KEY POINTS:
One of the newborn baby deaths that has sparked a review of maternity services could have been prevented, says a doctor acting for the family.
"This baby's death was avoidable," said Dr Ate Moala. "Unnecessary deaths from healthy pregnancies should not happen in New Zealand any more."
On Tuesday, Health Minister David Cunliffe ordered an independent clinical review of maternity services in Wellington following the deaths of babies in two maternity incidents.
The agreement that governs the access of lead maternity carers, mainly independent midwives, to hospitals will again come under the spotlight. It was criticised by Health and Disability Commissioner Ron Paterson in 2006 in a report on the death of a baby three days after a traumatic birth at North Shore Hospital - and was subsequently adjusted by the Ministry of Health.
Dr Moala, a public health physician, said the baby was delivered last month at Kenepuru Hospital in Porirua. The pregnancy had been normal, but the baby was overdue and was a "footling breech" - coming out feet first.
She described the baby's delivery and death - as told to her by the mother, a nurse - in an email to Mr Cunliffe, Director-General of Health Stephen McKernan and others.
The midwife, a new graduate, had failed to diagnose the feet-first breech presentation, Dr Moala said. The midwife attempted to deliver the baby in a water-birth, while her midwife-supervisor "looked on and assured the duty midwife that she was doing well".
"The baby's foot came out ... then eventually the bottom half of the baby's body came out."
The baby struggled to survive, while not yet completely delivered, for 20 minutes, said Dr Moala.
"No obstetrician or paediatrician or medical personnel support was called before or during the whole birthing process, until after the baby was delivered and not breathing.
"A 9 lb [4.08kg] beautiful Tongan boy died unnecessarily.
"There were enough concerns raised by the mother antenatally that the delivery should have been handed to a Wellington-based obstetrician.
"This pregnancy was 10 days overdue. Her previous baby was delivered by ventouse [a vacuum device]. The footling breech presentation was undiagnosed."
Dr Moala's email called for an urgent inquiry.
Mr Cunliffe said: "There needs to be clarity around the roles and responsibilities of those involved in maternity services in order to ensure women and their children are receiving the best possible care."
National Party health spokesman Tony Ryall said reviewing just Wellington services was too limited, because problems in maternity, such as shortages of midwives and overcrowding, were more widespread.
