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Communication with and assessment of young pregnant woman; transfer of care to stand-in midwife (13HDC00259)

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(13HDC00259, 24 June 2014)

Midwife ~ LMC ~ Stand-in midwife ~ Text communication ~ Assessment ~ Pain relief ~ Transfer of care ~ Stillbirth ~ Communication ~ Record-keeping ~ Rights 4(1), 4(2), 4(5), 6(1)

A young woman complained about the care provided by her Lead Maternity Carer (LMC). The young woman was pregnant with her first child and had a largely uneventful pregnancy. At 40 weeks and seven days' gestation, the young woman was in text communication her LMC, at which time she reported stomach pains at 15 minute intervals. The LMC advised the young woman by text message to take four Panadol at once. That night, the LMC also decided to travel out of town the following day. She did not advise the young woman of her plans and did not document their text communications in her notes.

The following morning, the LMC handed over the young woman's care to a stand-in midwife by text message before travelling out of town for the day. The LMC did not inform the stand-in midwife about her communications with the young woman the previous evening, and did not inform the young woman that she had gone off-call. The LMC continued to communicate with and advise the young woman, who reported that she was in a lot of pain, by text message over the course of the morning. The LMC was also in text communication with the stand-in midwife throughout the morning but did not relay the information provided by the young woman regarding her condition.

That afternoon, the young woman presented to the public hospital by ambulance. Staff were unable to find a fetal heartbeat and her daughter was stillborn with a true knot in her umbilical cord.

It was held that the LMC breached Right 4(1) in that she prescribed an inappropriate dosage of Panadol and failed to assess her condition and needs adequately or to make contact with the young woman in an appropriate manner. The LMC breached Right 6(1) in that she failed to inform the young woman that she was going off call and out of town or of the identity of her stand-in midwife in circumstances where the young woman was eight days overdue, in labour, and in regular text communication with the LMC.

It was also held that the LMC breached Right 4(5) with regard to her handover to the stand-in midwife in that the LMC did not advise her of any of the young woman's concerns from the previous evening or as they were communicated to the LMC throughout the morning after she had gone off call. The LMC breached Right 4(2) in that her record-keeping fell short of required standards.

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