Page Section: Centre Content Column
Assessment of woman in preterm labour (13HDC01460)
Download Assessment of woman in preterm labour (13HDC01460) (PDF 69Kb)
(13HDC01460, 12 June
Lead maternity carer ~ Community-based midwife ~ Assessment
~ Preterm labour ~ Rights 4(1), 4(2)
A woman who was pregnant with her fourth child, began feeling
what she thought felt like labour pains at 26 weeks' gestation. The
woman contacted her back-up LMC midwife who met the woman at
hospital and carried out an assessment.
The midwife felt that the woman had a urinary tract infection
(UTI). The woman did not produce a urine sample at that time,
so the midwife asked her to bring back a sample for testing. The
midwife did not perform a speculum examination, or discuss this
option with the woman. The woman went home and, later that
afternoon, her partner took her urine sample to the hospital to be
Later that evening the woman went to the hospital complaining of
lower abdominal pain. The woman was seen by a doctor, who noted the
woman's history, including that she had been seen by her midwife
that morning and that the midwife did not consider that the woman
was showing any signs of pre-labour. He noted that the urinalysis
indicated infection, and wrote a prescription for antibiotics. The
woman then returned home.
Just after midnight, the woman called an ambulance because her
pain was getting worse and she was transported back to the hospital
for assessment. At the hospital the woman was noted to rate her
pain at a score of 12 out of 10. Nursing staff contacted the
midwife to come in to assess the woman.
The midwife arrived and carried out an assessment. The midwife
then contacted the on-call obstetrician at the closest tertiary
hospital, and the decision was made to transfer the woman to the
tertiary hospital. Because of availability, there was a delay of
one hour in the ambulance arriving. The midwife did not carry out a
speculum assessment at that time.
The woman arrived at the tertiary hospital later that morning
and her baby was born soon after by vaginal delivery. However,
sadly, the baby died owing to problems associated with his extreme
It was held that the midwife failed to assess the woman's
symptoms critically, and she gave insufficient consideration to the
possibility that the woman was in labour. Accordingly, it was held
that the midwife did not provide services to the woman with
reasonable care and skill and breached Right 4(1).
By failing to comply with professional standards with regard to
the documentation of her assessments and care of the woman, the
midwife also breached Right 4(2).