A midwife who took 17 hours to attend to a pregnant woman experiencing her first labour has been found in breach of the Code of Health and Disability Services Consumers' Rights.
The Health and Disability Commission (HDC) released the findings of the investigation into the 2019 case on Monday.
The woman, in her 20s, was close to full term and home alone at the time. She had gone into labour and contacted the midwife to get advice about her contractions.
The midwife communicated with and assessed the woman via text but didn't visit her until 17 hours later. By this time the woman was close to giving birth.
The woman later told the HDC: "I later ... started bleeding and ... was crying for an ambulance."
"I had no indication that [the midwife] would be coming anytime soon despite constant calls and texts of urgency," she added.
The woman's sister-in-law later arrived and texted the midwife a photo of the woman's blood on a piece of tissue, saying: "This all just came out and keeps coming."
The midwife replied with: "Yeah the cervix has blood vessels so super common to have blood and mucus come away especially when you wipe," and "It's called a 'bloody show'."
At this point, the pregnant woman was "crying for any pain relief possible and asking for an ambulance to be called".
The woman's sister-in-law told the HDC: "Throughout the whole labour [the midwife] made myself and [the pregnant woman] feel as though we knew nothing and that we were overreacting.
"No patient should ever have to beg for care and it had gotten to the point where we had to send visuals to [the midwife] so ... she could see things were actually happening."
The woman went on to deliver a healthy baby boy by vaginal birth, but experienced complications after the birth.
She complained about the lack of care provided by the midwife before, during and after her labour, HDC said. The woman said she felt unsupported by the midwife, and her labour experience and subsequent illness were "unsettling and traumatic".
Deputy Commissioner Rose Wall said the breaches centred on the midwife not providing appropriate or sufficient information or communication about the progress of labour or pain relief options available to the woman.
She found the midwife breached Right 4 (1) of the Code by failing to provide services to the woman with the standard of care, support, and information she was entitled to during her labour and in the immediate 24 hours after delivery. The midwife also breached Right 4(2) by failing to appropriately document relevant information, Wall said.
"[The woman] did not receive the standard of midwifery care, support and information she was entitled to during her labour and over the following 24 hours in hospital after the delivery."
Wall said the findings highlight the importance of midwives providing individualised care in partnership with women and having adequate documentation.
The midwife, who is not currently practising, confirmed she has completed a midwives record-keeping course, began to work online, and has adopted a more sustainable working arrangement.
Wall recommended the midwife provide a written apology to the woman. She also recommended that the Midwifery Council consider the findings from this case should the midwife apply to return to practice in the future.
