A Queenstown mum’s traumatic labour was described during a hearing into her midwife’s alleged misconduct today.
The Health Practitioners Disciplinary Tribunal is meeting this week to hear the case of the midwife, who faces a charge under the Health Practitioners Competence Assurance Act 2003 following the birth on February 7, 2010.
The midwife, from the central South Island and referred to as Ms P, has interim name suppression. The name of the agency she works for is also suppressed.
The Queenstown mother is Sara Gutzewitz, who suffered a huge tear during the birth of her second child at Southland Hospital and required 140 stitches as a result.
The misconduct allegations against the midwife are:
– Failure to communicate to other midwives or clinical staff on duty that she had a medical anxiety condition, supraventricular tachycardia (SVT) that could potentially compromise care during labour
– Failure to disclose to Gutzewitz and her husband Conan Wilcox that she had SVT
– When she began to feel unwell and anxious during the labour, she failed to communicate this to her client and medical staff, potentially compromising the client-midwife partnership and the care she provided during labour
– After the completion of the second stage of labour and before the placenta was delivered (the third stage) she left the birthing room without ensuring adequate midwifery or medical care for Gutzewitz and her baby
– After leaving the birthing room she did not immediately ensure adequate midwifery or medical care for the mother and child.
The tribunal this morning heard evidence from Gutzewitz, her mother Jan Gutzewitz, Wilcox and Southland Hospital midwife Valerie Drake.
Sara and her family recounted that Ms P often left Sara’s side during the labour and when the baby was born – through a tear in the perineum – Ms P left the birthing room after putting the baby on Sara’s chest, without cutting the umbilical cord.
Wilcox walked outside the room to find Ms P sitting with her head in her hands in the nurses’ station, “telling the room that Sara’s perineum had ‘exploded’.”
Jan Gutzewitz described how she had to clear mucous from the baby’s nose and mouth, to make sure he was breathing.
Obstetrician Dr Keith Allenby, who worked on the night of Sara’s labour, arrived at the nurses’ station to hear Ms P talk graphically about the situation without her realising Wilcox was present. Allenby, who then went straight to the birthing room, gave evidence that he was shocked to find there was no midwife or staff member in the room assisting Sara and her baby.
“I was very upset on behalf of the patient,” he says.
“The fact that the cord had not been cut, the baby lay wet on the mother’s abdomen uncovered, and the patient was reported to have had a difficult birth was a concern.
“These factors also led me to believe that the midwife had exited the room very rapidly, leaving the delivery incomplete with no oversight of either mother or baby.”
He says the tear was “the most extensive and complex perineal tear I have seen in 20 years of obstetric practice”. He was so concerned about the events that he wrote to the Southland director or midwifery to record his concerns about Ms P’s “apparent mismanagement of her client”.
Ms P’s evidence says she agrees it’s unacceptable to abandon a mother and baby in that situation but her heart palpitations (SVT) – which occurred infrequently and never before during her work – was particularly severe. She maintains that hospital midwife Valerie Drake was present during the birth and that she asked her to stay and care for Sara while she left the room.
Drake, who assisted briefly during labour, says she was not present during the birth and was never asked by Ms P to handle the care.
Ms P’s lawyer Anita Miller says if her client is found guilty of professional misconduct, the case could have serious implications for “thousands” of Kiwi health practitioners – who might have a medical condition themselves but it has never before affected their professional work.
The hearing is set down for four days.