Safe births at home
The Commission prosecuted a midwife, Ms Jillian De Laile, before the Nurses and Midwives Tribunal. The Commission alleged that Ms De Laile had failed to provide safe care to two patients.
Patient A had given birth to twin boys at Ms De Laile’s residence. The second twin was in very poor health immediately after his birth and died ten months later. Patient B gave birth to a boy at her own home. The baby died shortly after delivery.
In relation to Patient A, the Tribunal found:
- Ms De Laile should not have accepted primary antenatal care in the last stages of a high risk pregnancy – it was inappropriate to plan a home birth, and the patient should have been transferred to a medical specialist.
- Ms De Laile had inappropriately assisted the patient to discharge herself from hospital against medical advice.
- Following the delivery of the second twin, Ms De Laile had failed to contact the hospital for advice and had not brought the baby to hospital for more than five hours, although she knew that the baby was in very poor health.
In relation to Patient B, the Tribunal found that Ms De Laile:
- inadequately monitored the baby’s heart rate and the mother’s vital signs
- should have arranged for an ambulance at various stages of labour, particularly when this had been requested by the patient
- should have called an ambulance immediately when the baby was not responding to resuscitation
- should have had a second midwife attend the birth
- not have left the patient on her own for almost two hours when the placenta had been retained and there was nobody with medical expertise to help.
The Tribunal found that Ms De Laile had shown a serious lack of judgment and a lack of insight into the standards expected of her as an independent homebirth midwife. On this basis, the Tribunal found her guilty of professional misconduct and ordered that she
be deregistered as a midwife.
The Tribunal also said that midwives offering home birth services should have a detailed written agreement with their patients, particularly about the circumstances when the patient should be transferred to a hospital. Independent midwives should also use the methods of note-keeping and observation required of midwives working in hospitals.