(File image). Photo: 123rf
A midwife who had two patients deliver stillborn babies and one go into intensive care has been told to apologise over the "poor care".
The Deputy Health and Disability Commissioner Rose Wall found the midwife breached the Code of Health and Disability Services Consumers' Rights on multiple occasions in her care of seven mothers and a baby.
The midwife was a self-employed maternity carer who had an access agreement with Health NZ Te Whatu Ora to use its maternity facilities and birthing units.
After the stillbirth of a baby in 2021, Te Whatu Ora wrote to the Midwifery Council with concerns about the care the midwife had provided to the mother of the stillborn baby.
Te Whatu Ora said it had "ongoing concerns" about the midwife's competence, and concerns for the women in her care. Health NZ suspended the midwife's access to its maternity facilities and birthing units.
It wrote a second letter to the council detailing concerns it had about the midwife's care for six other clients between 2017 and 2021.
Two women delivered stillborn babies under the midwife's care, with one mother developing multiple organ failure which required time in the intensive care unit.
She was subsequently diagnosed with acute kidney failure, postpartum haemorrhage, and HELLP syndrome (a severe type of pre-eclampsia).
In her decision, Wall noted there were emerging themes regarding the midwife's practice, which included documentation not meeting accepted midwifery standards, lack of documentation of consultation with, and handover to, secondary care, sparse documentation of assessments and of phone discussions, lack of patient history review and lack of baseline observations to determine fetal and maternal wellbeing during critical stages of labour.
"The numerous failures by [the midwife] represent a pattern of poor care and, overall, the care provided by [the midwife] was not in keeping with the standard reasonably expected of a midwife," she said.
Wall found the midwife breached Right 6(1) for failing to provide one of the women with information she was entitled to receive under the Ministry of Health's Guidelines for Consultation with Obstetric and Related Medical Services.
The midwife also breached Right 4(1) in her care of three women, for failing to recognise a condition that required consultation with another medical practitioner, perform palpation and maternal baseline observations, monitor maternal and fetal wellbeing and perform ongoing observations at critical stages of labour, and respond with timely and appropriate interventions when there were indications of difficulty.
Wall also found that the midwife breached Right 4(2) in her care of five women for the standard of her documentation.
The midwife is no longer practising and Wall has recommended her to provide written apologise to six of the eight affected clients she cared for.
Wall has also recommended that if the midwife returned to practice that she should undertake the full required training recommended by the Midwifery Council.