An obstetrician at a misconduct hearing for a South island
midwife described a birth in which a mother needed 140
stitches as a "horrific event".
The midwife is in Queenstown facing a charge of professional
misconduct relating to the ''horrific event''.
Auckland-based Keith Allenby said the mother sustained ''the
most extensive and complex perineal tear'' he had seen in 20
years' obstetric practice.
The charge, under the Health Practitioners Competence
Assurance Act, was the midwife, known as ''Ms P'', acted in
such a way that it amounted to professional misconduct
between January 20, 2010, and February 7, 2010, while caring
for her client, Sara Gutzewitz, and her son Francis
(Frankie), born on February 7, 2010.
During the first day of a Health Practitioners Disciplinary
Tribunal hearing in Queenstown yesterday, Dr Allenby, an
obstetrician and gynaecologist at Counties Manukau District
Health Board, said the tear Ms Gutzewitz sustained was caused
after the baby was born through her perineum.
In a letter written to the Health and Disability Commission
in March 2010, her husband, Conan Wilcox, said Ms Gutzewitz
required about 140 sutures following Frankie's birth.
Immediately after the birth, Ms P, a midwife based in the
central South Island, allegedly left the couple with their
newborn son before the umbilical cord was cut and the
placenta delivered.
Evidence given yesterday stated the baby had not been dried
or cleaned, had not been covered and had not been given
appropriate skin-to-skin contact with his mother, who lost
about a litre of blood following the birth.
Ms P's lawyer, Anita Miller, of Wellington, said her client -
who is yet to give evidence - was suffering from an episode
of supraventricular tachycardia, a heart rhythm disturbance,
characterised by palpitations, causing her to feel faint.
She had been diagnosed with the condition in 2003, but it had
never before affected her abilities to perform her duties as
a midwife.
Ms Miller said her client had asked another midwife, Valerie
Drake, of Invercargill, to assist with an episiotomy and then
temporarily look after Ms Gutzewitz and her son as she needed
to leave the room.
Ms Drake admitted preparing the tools for the episiotomy. She
said she was then asked by Ms P to go to find an
obstetrician, believing Ms P had stayed with the woman who
had not yet delivered the baby. Ms P ''did not at any point''
hand over care of Ms Gutzewitz, nor advise her she was
feeling unwell.
Ms Gutzewitz said following the episiotomy she was in so much
pain her body was ''going numb'', with Frankie born soon
after through a tear in her perineum.
''I remember that [Ms P] dumped Frankie on my tummy
immediately after the birth.
''I was in such pain and was so exhausted that I could not
even pick him up.
''[Ms P] left the room without saying anything to me.''
After her husband followed Ms P, her mother, Janis Gutzewitz,
had to clear the mucus from the baby's mouth and nose.
''There was no-one else in the room to help us. I felt
completely abandoned, exhausted and upset,'' Ms Gutzewitz
said.
Dr Allenby arrived at the nurses' station and said Ms P was
sitting with her ''head in her hands''.
''She was exclaiming to the room words to the effect of `Oh
my God ... it was horrible ... her perineum exploded ... that
was disgusting'.
''I noticed a man standing at the second door to the nurses'
station immediately behind [Ms P], who was unaware of his
presence. I now know that man was Conan Wilcox, who could
hear every word that [Ms P] was saying.''
Dr Allenby went to Ms Gutzewitz's room to find her without
medical staff and said he was ''shocked'' at what he saw.
Concerned the baby was getting cold, Dr Allenby said he went
to pick the baby up and dry him ''at which point Sara cried
out and I discovered the cord was still attached''.
''I was very upset on behalf of the patient.
''The fact that the cord had not been cut, the baby lay wet
on the mother's abdomen uncovered and the patient was
reported to have had a difficult birth was of concern.
''These factors also led me to believe that the midwife had
exited the room very rapidly, leaving the delivery incomplete
with no oversight of either the mother or baby.''
Dr Allenby demanded Ms P return to the birthing room and
''finish your job'', which she did, and said he was angry the
patient had been left in so much pain without any midwifery
support for the third stage of labour, which carried
significant risks.
Later that day, he wrote to Southland director of midwifery
Jenny Humphries about his concerns.
It was the first time in his career he had written a letter
of complaint about a midwife, he said.
He said he was one of the most ''pro-midwife people you could
come across'' and if something was ''sufficiently
disconcerting that I'm prepared to write a letter to the
director of midwifery ... then I can tell you I'm shocked''.
''It was a cluster of things ... we have a situation where
something has gone wrong for a woman who's just delivered ...
this was an horrific event that is a cluster of events
concerning a delivery.''
The hearing continues today.
