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Provision of antenatal and labour care (05HDC01760)
Download Provision of antenatal and labour care (05HDC01760) (PDF 142Kb)
(05HDC01760, 22 November 2006)
Midwife ~ Lead maternity carer ~ Birthing unit ~ Midwifery
service provision ~ National guidelines ~ Antenatal and intrapartum
care ~ Neonatal resuscitation ~ Rights 4(1), 4(2), 4(4),
A woman complained about the antenatal and labour care provided
by her LMC. She complained that the LMC did not attend her
appointments regularly, and did not attend to her when she reported
reduced fetal movements. The LMC was called for the labour but
missed the delivery, leaving an inexperienced midwife to deliver on
her own. The baby was stillborn.
It was held that the LMC failed to provide services of an
appropriate standard in the provision of antenatal care in that she
did not provide services with reasonable care and skill; did not
act in accordance with relevant standards and legislative
requirements; did not appropriately ascertain and respond to risk
issues; and did not provide care consistent with the woman's needs.
She was not available to the woman at all times and did not provide
an alternative back-up midwife in her absence. The LMC was found to
have breached Rights 4(1) and 6(1).
It was also held that the birthing unit did not have adequate
midwifery cover for labour and births, and did not have adequate
emergency systems in place, in breach of Right 4(2). It also did
not provide adequate access for the administration of emergency
drugs in a resuscitation situation, in breach of Right 4(4).
The delivering midwife was alone and delivered the baby
unexpectedly. Her actions were held to be reasonable in the
circumstances, and she was not found to have breached the Code.
The LMC was referred to the Director of Proceedings, who laid a
charge before the Health Practitioners Disciplinary Tribunal. The
Tribunal concluded that given a reported lack of fetal movements,
the LMC failed to respond appropriately by ensuring a kick chart
was commenced, or a CTG undertaken and interpreted. She also failed
to attend in a timely manner, failed to notify of an anticipated
delay, and failed to provide adequate information or handover to
the maternity facility. The Tribunal found that these actions
amounted to such a significant departure from the accepted
standards that discipline was warranted, and it upheld the charge
of professional misconduct.
Penalties included supervision/monitoring of the midwife for a
period of two years; a limit of no more than four midwifery cases
per month for a year; a recertification audit by the Midwifery
Council; a New Zealand College of Midwives Midwifery Standards
review; a fine of $2,080, and a penalty of censure.The Director
decided not to issue proceedings before the Human Rights Review
Link to Health Practitioners Disciplinary Tribunal decision: