Midwife's competence questioned

The woman had engaged an independent midwife. Photo / iStock.

A midwife's competence has been questioned after she failed to arrange urine testing for a woman who was later diagnosed with a life-threatening condition that necessitated an emergency caesarean birth.

The woman had engaged an independent midwife after she became pregnant with her first child in 2012 when she was aged 34.

The midwife did not weigh the woman or test her urine at antenatal appointments and kept minimal records, says Health and Disability Commissioner Anthony Hill in a report released today.

At 38 weeks in the pregnancy, the woman's blood pressure was checked and noted to be high by a student midwife. The midwife took no further action and did not document rechecking the high blood pressure reading. A week later, the student midwife checked the woman's blood pressure and recorded it as normal, but this was not checked by the midwife.

Following an episode of chest pain -- during which she spoke to the midwife by phone -- the woman went to a hospital emergency department at night with upper abdominal pain and high blood pressure.

She was diagnosed with a life-threatening variant of pre-eclampsia, a condition characterised by high blood pressure and a large amount of protein in the urine. The baby was delivered by emergency caesarean and the mother needed to be transferred to an intensive care unit.

Mr Hill says that by failing to carry out antenatal urine testing and by not responding appropriately to the woman's high blood pressure, the midwife provided sub-optimal care.

He recommended she do further training and asked the Midwifery Council to consider reviewing her competence.