The Knives Are Out – Again

The Obstetric sites are licking their lips discussing a UK homebirth where the mother died from an haemorrhage following an inverted uterus. Much was made of the homebirth midwife’s lack of confidence to put in a cannula. This is strange since the paramedics came promptly and it is really an emergency scene where they are specially trained to insert cannula’s quickly into people shutting down because of blood loss. It appears the midwife did the best thing and waited moments for the experts to arrive. Most hospital midwives don’t insert cannula’s on a regular basis and I’m sure in a crisis would rather the expert in complexities do a great job instead of them doing a botch job.

from the mirror

The layout of 23-year-old Joanne Whale’s home hindered efforts to carry her out flat on a stretcher. It meant the child-minder did not arrive at hospital until more than an hour after giving birth to baby Jessica. Midwife Julie Bates also told how she felt unable to insert a fluid line into Joanne.

The midwife called the paramedics as soon as there was a problem and they arrived quickly. However they didn’t get to the hospital for an hour. That was hardly the homebirth midwife’s fault. When she arrived at the hospital Joanne Whales was alive. She didn’t die for another 6 hours.

There was a another delay because doctors were not told that she needed surgery on an inverted uterus. Joanne, of Ipswich, died six hours later. The greater Suffolk inquest blamed the complications for her death.

The homebirth midwife told the hospital midwife the problem who in turn didn’t hand this over. The Ob clearly couldn’t have checked her out. If she was bleeding that much it wouldn’t have mattered whether or not they knew the absolute detail. Why didn’t the Ob look at the woman sooner?

How can it be the fault of the homebirth midwife, that the woman died 6 hours after they got to the hospital?

Taken from EADT

As a result of the body being in so much shock her blood lost the ability to clot and this caused extensive bleeding, the inquest heard.

In the 6 hours at the hospital didn’t anybody notice that she was going into DIC?

This clearly shouldn’t have happened. An inverted uterus could happen at home or at the hospital. The woman didn’t die for 7 hours, 6 of which were at the hospital. Even if the medics didn’t know from their own midwife that the woman had an inverted uterus, surely someone should have picked up her condition sooner.

What exactly does this have to do with homebirth? I am totally confused about it. The Obstetric blogs have conveniently failed to mention the Obstetrician who either didn’t ever look at this woman or who failed to correctly assess her condition FOR 6 HOURS.

It seems to me the witch hunt will never be over.

9 responses to “The Knives Are Out – Again”

  1. I am Brooke...

    FAR OUT.
    They don’t let up do they. I really feel for this woman’s family first and foremost, and secondly for the midwife who had a birthing woman pass away despite her best efforts to get help where she felt she needed it.
    This death has NOTHING to do with homebirth, NOTHING.

    As you say Lisa, it’s about the hospital failing to do an appropriate handover between careproviders and the hospital failing to adequately assess the woman BLEEDING TO DEATH. Surely regular obs on the woman would have given an indication of a massive bleed, surely they had her being observed at all times? Where is the logic in this case?

    Pass the buck anyone?

  2. Michelle

    Like you say, this has nothing to do with homebirth at all. It’s unbelievable that they (the Judge I think) made a big deal about the midwife not giving IV fluid, and yet nothing was said about the appalling lack of care that meant a woman in a hospital with a complication was neglected to the point that she died. I would say that this highlights the dangers of inadequate care in hospitals more than anything else.

  3. Cryptic Automaton

    Yep, physicians can cover ass better than a pair of Levis and use more smoke and mirrors than Penn and Teller. Unlike their Masonic counterparts in the police force their victims rarely survive to tell the tale and there’s no video evidence to reveal their fuck-ups. Internal inquiries amount to passing the shit onto some other poor bastard or if that fails there the reliable old chestnut “surgical complications”, which translates to “we fucked-up, but there’s snowball in hells chance of us admitting it”. Let’s face it, the only time you’ll pull the rug from under a physician is when they foolishly leave their patient survive after removing a leg instead of a tonsil.

    It’s not surprising to learn that more people die in hospital than anywhere else. But as only sick people frequent hospitals there’s no headline being made when the people that walk into the place fail to walk back out.

    Half of these physicians should read into their history and move back into the barber’s shop. At least most people can live with a bad hair cut.

  4. pinky

    I think it has a whole bunch to do with the safety of homebirth and hospitals. I do not have all the information. And the information I do have does not make much sense.
    1) Midwife not able to insert IV.
    2) EMt not able to insert IV.
    3) Didn’t anyone at the hospital notice she was in critical condition when she came in? 4) Why wouldn’t the homebirth midwife give report directly to the Doctor who is going to care for this patient?

    It speaks to not only inexerience but lack of communication and lack of any semblence of team work.

    MOre of the story is missing. I just can’t fathom a whole team of Doctors missing and inverted uterus. But I can fathom if multiple mistakes were made over time, this woman could die. It has happened before. It has been addressed and studies. Pointing the finger at one person is not really going to be a productive inquirey.

  5. Lisa Barrett

    Pinky, I agree with you. There was some terrible communication and a few questionable events throughout the whole thing.

    I also agree about the reporting to the Doctor, I speak directly to the the medics if there is a transfer. Also. I am well known and received with respect and concern. ( who cares what goes on behind my back,) at my main hospital of transfer. I rarely go so when we are they know we need serious help.

    I just really don’t understand why it means that homebirth is unsafe. It actually means there are faults in the process of care that could be looked from every angle.

    I wonder why she had an inverted uterus?

  6. Midwifery is catching

    I wondered that as well. And also how she managed to linger for 6 hours after going to the hospital, all the while bleeding to death. If she’d died of something like an embolis or stroke then sure, that can be immediate and impossible to treat in a home setting but also equally hard to treat in a hospital with only a slightly higher chance of success. But an inverted uterus? With blood loss? How is that missed?????

  7. Sarah Stewart

    Sorry to be completely off topic, but I just wanted you to know that I have pinched your comment policy as the foundation of the policy I have just developed for my blog as part of the 31 Day Comment Challenge:

    Thanks a lot Sarah

    PS: I agree that my blog titles could be spiced up but I am hopeless at that. Any suggestions are gratefully received :)

  8. Lisa Barrett

    Thanks Sarah for the heads up; I checked out your new policy. good work.

  9. Anonymous

    No one is after the Midwife involved, nor are they trying to desuade mothers from home birth. What was said at the inquest is that there are safety issues to be addressed such as suitability of the mother and the home for the purposes of home birth. The fact of the matter is that there were several bad judjement calls and a young woman died. surely we owe it to her to ensure lessons are learned?