KEY POINTS:
Two midwives have been censured for their lack of care and skill during a home birth of a baby boy who died several hours after they delivered him.
Health and Disability Commissioner Ron Paterson ordered one of the midwives, known as Ms D, to write a written apology to the family.
The second midwife, known as Ms E, has already apologised to the couple.
In a newly released report into the child's birth and subsequent death after being transferred to hospital, the commissioner found Ms D failed to provide vital information regarding the slow progress of the woman's labour.
He held she breached the code by failing to provide the mother and baby with services of reasonable care and skill, that complied with professional standards.
Ms E failed to adequately document the progress of the labour and when problems arose did not communicate properly with the mother "adequately or soon enough".
The case was referred to the commissioner in June 2006 after the parents, known as Ms A and Mr B, complained about the maternity care provided by their lead maternity carer (LMC) and the two back-up mid-wives.
Ms E, the more experienced midwife, was called on for back-up part way through the labour.
Ms D was less experienced and assumed the role of the lead maternity carer and had overall responsibility for the management decisions made at the delivery.
An investigation was launched on August 9 that year.
The 40-year-old woman, who was giving birth for the first time, and her partner had chosen a home birth and an independent midwife who had an interest in natural health and alternative therapies.
There were no complications during the antenatal period but complications developed during the birth.
The woman had a prolonged second stage of labour and the birth was complicated by a shoulder dystocia and the baby was born "flat and toneless".
After being taken to hospital the parents decided to withdraw active treatment and the baby died in his mother's arms a short time later.
The commissioner found that while aspects of the LMC's care were "less than optimal" her deficiencies did not amount to a breach of the Code of Health and Disability Services Consumers' Rights.
"This case highlights the importance of adopting a low threshold and seeking extra assistance promptly when there are concerns regarding prolonged labour," Mr Paterson said.
"This is especially important for home births and where the attending midwife is relatively inexperienced."
The case also highlighted the importance of keeping comprehensive records and the need for good communication between the LMC and the woman and the different midwifery staff involved in the woman's care.
Ms D should have called for specialist assistance when the baby's heartbeat could not be detected between 5.05am and 5.37am, the commissioner found.
The commissioner commended Ms E on her "prompt and unreserved admission of responsibility" to the couple during the investigation.
- NZPA
