An independent midwife faces possible legal action over failures in the care she provided during a nightmare birth two years ago.
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Details of the case at an unnamed base hospital have been released by the Health and Disability Commissioner.
A second-time mother, Mrs A, had a long and painful labour until the baby's shoulders became stuck, triggering a medical emergency.
The midwife used force to deliver the baby girl, who recovered.
Mrs A, however, suffered blood loss and a major tear that required transfer by ambulance to a larger hospital.
Commissioner Anthony Hill said the midwife knew Mrs A was having a very large baby, but failed to measure her growth correctly, failed to recognise when the labour was no longer normal, and failed to recommend a specialist be consulted.
The Midwifery Council suspended the midwife last year.