Following the Coroners decision earlier this year to give himself Jurisdiction on a baby who had a PEA after birth with no sign of life, I would like to question his decision. The transcript of his findings were in contradiction to his experts and in my opinion the law. After seeking advice I have applied for a Judicial review. We also applied for the inquest to be postponed until after the review. The coroner held a small hearing last week where he declined to postpone so we went on to an emergency hearing at the supreme court. We were granted an injunction to make the coroner postpone and the right to be heard. A date will be set soon. The process is massive, scary and it appears that I am up against the coroner, the Health department, the Ambulance service and the Attorney General.
This is a case of world interest, the rights of the coroner, the power of law over the common man and the definition of life. I find it completely frustrating and frightening that when the case was at the coroners court there were press making our lives hell. We were on the tv and in the newspaper. Nobody in the media questioned his decision. State line Had a diabolical show about the Coroners rights and didn’t even question whether it was right or wrong. The AMA who it potentially affects made it about homebirth. Oh this case is a homebirth but the ruling will apply to everyone. The definition of life. One death at a homebirth and 3000 deaths at the hospital last year proves this.
Quietly, with no press, no fuss and no outside help We have at least won the right to be heard.
I would like to thank all my friends, clients, birth activists and family for their undying support and their financial generosity.
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I never had a home birth but I know so many ladies who have, and to them it was a beautiful and magical experience. For them to take away peoples rights to choose where they give birth is disgusting! I hope you win and I support you 100%!
In 1985, my partner Mary and I went through a 6 year court case here in Canada which was incredibly expensive both to us and our government. It is so daunting for an individual to be up against the “powers that be”. We were completely acquitted of all charges by the Supreme Court of Canada in 1991. I look back on those 6 years as a very bad dream.
What was explained to us as the reason why laws are enacted to determine when the fetus becomes a “person under the law” is that no doctor would attend a birth in the hospital if he/she could be criminally prosecuted for ‘negligence’ if a baby died during birth. Doctors have been known to work drunk, drugged or otherwise impaired and, even then, they are not charged criminally (civil cases can be brought but that is a very different matter from criminal).
Because all people are supposed to be “equal under the law” it becomes a dilemma when a baby is stillborn with a midwife because then, some physicians want to make a different law for the midwives. That is illegal, of course, but doesn’t stop them from long expensive and highly publicized legal wrangling.
The newspapers are the worst enemy because they want to “sell” stories and the stories that the public wants to read are as shocking and accusatory as possible. I have never spent a nickel on a newspaper since I went through my court case. The only time I read a paper is if someone else leaves it behind in a coffee shop. I know how dishonest their reports are.
Can you put the address and info for donating money here again so we can do more fundraising? This is an important case for everyone. Thanks for being willing to do it, Lisa. At the end of the day, it will come out right but the middle part is not fun. Love Gloria Lemay, Vancouver, BC Canada
Yes, please do post the information for donating money again. This is indeed an important case for everyone, but we also just want to support you through it.
oh, lisa… i’m thinking about you. i’m trying to run this through my head, my husband’s, and my mentors… in the US, if the parents were sovereign, the coroner wouldn’t have jurisdiction. i’m wondering if you can be sovereign in australia.
what’s next ~ claiming jurisdiction over an act of God?
i’m wondering if there isn’t something that the parents of the child that died could do… they have a right under God to choose the provider they want ~ or UC, right? what is the UC status in australia? (i guess this might be irrelevant, as i suspect that deeming UC illegal is unconstitutional)
you are in my prayers…
p
blessings,
paule
I had my first child twenty one years ago, with the help of a de-registered homebirth doctor.It is my understanding that the reason he had been de-registered was in relation to the death of a child in a homebirth situation. In all the intervening years, has nothing changed? Yes, it has… it seems to have gotten worse. A womans choice is apparently a contradiction in terms in relation to the birthing process.
I’ve been following this sad story, and I’m still a bit confused by what it is you feel will be lost or gained if the inquest is pursued.
If the baby had a vigorous heartbeat prior to becoming stuck in the birth canal, and it took 20 (or 40 as I’ve read in some media) minutes for the baby’s body to be fully birthed after her head had already been birthed, isn’t the cause of her death due to the shoulder dystocia and the subsequent loss of oxygen as a result of the umbilical cord being constricted?
I’m confused why you would choose to claim that she was a stillborn baby when she was not stillborn when her head had been birthed. What is the benefit to anyone, doctor or midwife, to claim she was stillborn if she did, indeed, die from being stuck and losing oxygen? This seems acutely different than a baby that dies prior to the onset of labor.
This is a very sad case for all involved, and I am a homebirth advocate. I just fail to see how this is an issue that sheds favorable light on midwives at all. Can you explain further? I’m genuinely interested.
Kind regards,
Lou
Dear Doula Lou
There is nothing to be gained by an inquest and the parents certainly do not want one and I agree with them. A Still birth is a baby who dies prior to the complete birth. This isn’t about shedding a favourable light on midwives. In fact The post you are commenting on has nothing to do with homebirth or midwives. The case at the supreme court is simply to push for a judicial review after the finding of the deputy coroner in their determination of holding an inquest while considering what is life, when does it start, who is a person etc etc. This could be any birth, at home or at the hospital.
Shoulder dystocia happens at the hospital. Check the internet, there are cases where they have done hideous things to get babies out way after they have passed away. This has NOTHING to do with being a homebirth. Do not believe anything the media says because most of them are not interested in the truth only in a sensational story.
You mention you were up against the Ambulance Service… could you explain this a bit more. Im a Ambo, have been involved in a resuscitation of an infant after a home water birth (I was a nurse before becoming an Ambo). Im not against home births per say (and believe in choice). Jst wonder why are the ambo;s giving you grief (I gather it was their moinitor that detected PEA)?
I wasn’t up against them, it turns out the crown was acting for the coroner, health department, ambos and the attorney General. In the State of SA the head of the service belongs to the AMA. As an ambo your role is to go to an emergency. You have been to 1 homebirth emergency that hardly makes homebirth unsafe. Far more things happen at the hospital than ever happen at home.
A coronial investigation is initiated the state believes that there is something to be gained from the inquiry which can prevent similar events occurring in the future. The majority actually involve deaths in hospital but also include gaols, nursing homes and psychiatric institutions. Road accidents and construction mishaps like the Riverside Golf club collapse are also included. The purpose is not to prosecute but a process of discovery and to protect the public interest. Although he has great power to subpoena documents and witnesses, none of his recommendations are legally binding. The process is transparent to the public and reports are available for viewing online.
The process until recently hasn’t been transparent at all and in fact in WA nothing is available on line. I believe the coroner has no jurisdiction to investigate this case. The experts brought in by his own office agree, the law agrees. It appears that it is thought coroners can do anything they want..
If the baby had transient signs of life after delivery but then expired shortly after, would it be a coroner’s case?
If there is life signs that are well defined the baby is born alive. The Coroner can hold an inquest if he wants to. At the hospital they mainly don’t. At Home even if the baby has a condition that is not compatible with life. So could not live because of an abnormality of some sort, the coroner will do everything in his power to investigate. This is regardless to the wishes of the parents or the evidence in front of him. There again, the coroner doesn’t take into consideration the evidence of the Medical experts if it is against what he wants to do. In this case the Attorney General discredited the experts even through they were the coroners own experts. Because the experts all agreed that the baby was still born but it wasn’t want the coroner wanted. I don’t believe that the coroner should have whatever power he feels like. Surely the common man deserves some protection, if there is no line in the sand what happens to the right to termination? Personage of the fetus leaves women without the right to chose what she wants . Makes her an incubator and gives the establishment the control of her body.
Do you believe that the original legal interpretation of life outdated in the light of current medical understanding and ought to be revised in the future?
I don’t think current medical understanding has changed when it comes to signs of life. Analogy from a friend – There is good electrical current in the socket and you plug in a broken fan. The fan does not work. The current is there and available but doesn’t drive the fan because the fan is broken. You cannot say the fan was ok just because there was a current in the socket.
A PEA has to be available in the body for organ donation. If it is a sign of life you cannot just take the organs from a live person. Will they have to stop doing it? What do you believe? What current medical understanding are you talking about? Do you think they should change the law to suit themselves? Lets not pretend that there isn’t an agenda here. The Attorney General implied that it was only because we weren’t at the WCH. This is totally untrue. Check out deaths from Shoulder dystocia and see. Will every baby at the hospital that is still born (3000 in Australia last year) be checked for a PEA? OR is it only to control births outside the hospital?
Lisa, once again your information is incorrect. For an organ donation to occur a person has to be declared brain dead. In these situations there is still a heart rythmn providing a cardiac output due to the use of ventilation and inotropes. In some instances organ donation may occur when brain death hasn’t occurred. In the setting of a patient having a terminal condition and is only alive because of ventilatory and inotropic support. In these instances when these supports are withdrawn the criteria for donation is the absence of a any cardiac output( ie blood pressure) within 5 mins of support being withdrawn. The rythmn the patient is in at the time is of no importance.
PEA is a treatable rythmn, and potentially reversible. Algorythmns for it’s treatment have existed for years. If you believe that this baby was stillborn why did you call an ambulance, commence CPR and resuscitation efforts?
“Check out deaths from Shoulder dystocia and see. Will every baby at the hospital that is still born (3000 in Australia last year) be checked for a PEA?”
I would say that if you recorded fetal heart tones during labour then the baby should be considered alive whether or not there are signs of life when baby is delivered. In answer to your question I think it is quite reasonable for rthe Coroner to investigate shoulder dystocia hospital deaths using the above crieria. If the process helps us identify babies at risk this may then reduce the number of deaths that occur each year. I think a stillbirth should be labeled as such if there is no fetal heart beat noted at the onset of labour or prior to it commencing. It may not be a Coroner’s case but certainly an issue that is worth researching.
Once again maybe read the research on shoulder dystocia, it is unpredictable and the average baby size is 3800g. There are some cases when they have to do a destructive delivery. A good google will show you . So what do you think about a late abortion? They have a heart beat prior to the procedure? Should they all be coroners cases or should it just not be allowed.
What is an issue worth researching I don’t understand what you mean? The coroners process often identifies nothing and is there mainly to point a finger in these situations. Even the poor woman who lost her baby at 28 weeks and is pushing for investigations only wants to find someone to blame. In health, the coroner is known to make rulings that go against all current evidence and thinking. E.g. The GBS case in Mt Gambier. It appears they have no checks and balances. How can it be that a coroner can call 2 expert witnesses and when they agree the baby was still born and the pathologist concurs that he will agree, then firstly the coroner can dismiss their evidence because he doesn’t like it. Then at the supreme court they can say they actually weren’t expert after all. That Dr Pepperall the Ob/gynae, was not an expert in this matter and Gavin Wheaton the paediatric Cardiologist may not know enough about new born babies. This is about the fundamental definition of life and about the Power of the coroner to act within the law.
This does not take away the grief or reality of what happened in this situation or any other.
a Still birth is a baby who is completely born but has no signs of independent life.
Risk factors associated with shoulder dystocia:
http://www.shoulderdystociainfo.com/anticipated.htm
4500 g = 22.6% chance
Coronial conclusions are a separate issue to the public interest of coronial investigations.
Legal eagle, I went to the document you quote and I think you’re being disingenous by posting only a part of that information. Are you really interested in an intelligent interchange of information. The part you mention pertains to babies who are extracted with forceps or vacuums. That is not applicable to this case.
Also, later in the item posted it says:
Begin Quoted material: “So, can shoulder dystocia be reliably predicted?
Up until this year, both the short and the long answer to this question would have been: “No”. Nowhere in the literature were there studies that showed that the sensitivity or positive predictive value for predicting shoulder dystocia was high enough to justify interventions. While macrosomia, diabetes, prolonged second stage of labor, instrumental delivery, and other factors do indicate a statistically increased risk of having a shoulder dystocia, their low positive predictive value and high false positive rate make them clinically useless as tools for predicting — and hence trying to prevent — shoulder dystocia.” end of quoted material.
Gloria, it may be impossible to have a tool with 100%. This commercial-in-confidence multivariate tool claims 50-70% sensitivity and > 97% PPV. However, the important philosophical question is at what level of potential risk would be considered excessive when immediate intervention facilities are not available. People may accept a high risk but informed consent dictates they should be aware of it prior to undertaking that option.