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Antenatal and postnatal care provided by a midwife (12HDC01474)
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(12HDC01474, 11 April
Community-based midwife ~ Lead maternity carer ~ Referral ~
Growth ~ Post-natal care ~ Rights 4(1), 4(2)
A woman complained about the care she received during her
pregnancy and following the birth of her baby.
When she became pregnant with her first child, she engaged a
community-based midwife as her Lead Maternity Carer (LMC).
At 35 weeks' gestation, the LMC noted no growth of the fetus for
one week, and the woman was referred for an ultrasound scan. The
LMC recommended that the woman have the scan within the next week.
One week later, the scan was performed and it revealed
abnormalities that required urgent referral to the hospital. The
LMC was informed of the scan results. A midwife at the hospital
then contacted the LMC and asked that the woman come into the
hospital that day for blood tests. The LMC subsequently sent the
woman a text message asking her to go into hospital if she
Although the woman did not understand the urgency of the
request, she went into hospital later that day and was subsequently
admitted for monitoring. The baby was delivered two days later by
Caesarean section and admitted to the Neonatal Intensive Care
The LMC saw the woman in hospital twice following the birth. The
woman was then seen by the back-up midwife at home because her LMC
was on leave. When the LMC returned from leave a visit was arranged
but later cancelled by the LMC. The woman subsequently transferred
her care to another midwife.
It was held that the LMC failed to recognise the need to refer
the woman for a scan in a timely manner when the baby's growth
stopped. Following the receipt of the scan results, the LMC failed
to respond to the urgency of the situation and, as a result, did
not adequately communicate to the woman the need for urgent
follow-up. The LMC also failed to provide adequate postnatal care
that met the woman's needs. The series of failures in the care
provided by the LMC suggested a pattern of suboptimal care,
breaching Right 4(1).
By failing to maintain adequate contemporaneous antenatal
records, record her postnatal visits and any discussions and
decisions in relation to ongoing management, the LMC failed to meet
the standards set by the Midwifery Council of New Zealand and also
breached Right 4(2).