A midwife facing professional misconduct charges after a baby died following a prolonged pregnancy insists she warned the mother her baby could be put at risk from being overdue.
Monique Kapua is facing the charges after the Northland mother, whose name is suppressed, delivered a stillborn son in September 2006 after her pregnancy went two to three weeks overdue.
The accusations include not providing adequate information to the mother about care options, particularly regarding induction in the event of prolonged pregnancy.
Ms Kapua was also alleged to have not documented her care adequately and of taking leave about the time the woman was due to give birth, without making adequate alternate care arrangements.
Speaking at a Health Practitioners Disciplinary Tribunal hearing in Auckland today, Ms Kapua gave what was often a conflicting view of events to that given by the mother on Monday.
Describing herself as a traditional Maori practitioner who embraced a whanau approach to the health and wellbeing of children, Ms Kapua listed several medical qualifications and described how she had been highly commended in several medical reviews.
Ms Kapua said she had initial reservations about taking on the care for the woman once she realised she was not Maori as she wasn't sure she could meet the woman's cultural expectations.
However, the woman said she had an affinity with Maori and "reiterated she wanted home birth; she also said she didn't want any medical intervention, two things I felt strongly about".
Ms Kapua said she told the woman about a number of antenatal care options, but that "(the woman) stated that she was a healthy woman and did not want clinical care".
She said the woman declined to take more than three blood pressure tests as well as urine analysis.
Ms Kapua said she discussed the woman being overdue at the 41 week stage of her pregnancy.
"I stated that 'baby could be put at risk'," Ms Kapua said.
She said consultants would be concerned about how long the placenta would last, the movements of the baby and what would be normal with heart beats.
Ms Kapua said she told the woman that a consultant usually said "some babies die when you go overdue", that they said there was usually a better outcome if induction was done at the 40-41 week stage, and that the risk got higher every week.
"I also informed her there is a piece of research that challenges this view."
The evidence conflicted with that of the mother, who said Ms Kapua never discussed any risks of prolonged pregnancy with her.
Ms Kapua said the mother had said she didn't want anything about her pregnancy documented.
She said she entered a record of events on a computer system retrospectively using diary notes with the permission of the mother and with an administrator present.
Ms Kapua became tearful at times, especially while discussing the baby's stillbirth, and apologised to the woman and her husband for any distress they may have suffered.
But she also said some of the woman's allegations were "unprofessional and crude" and an assault on her integrity.
A nursing assistant employed by Ms Kapua, Sandra Harris, said she attended an early visit by Ms Kapua to the woman.
She said the woman expressed a desire for a traditional Maori home birth and did not want a number of normal tests held during pregnancy taken.
Penalties Ms Kapua could face if found guilty include fines, suspension and being struck off as a practitioner.
The hearing will next convene either next week or the week after, when Ms Kapua will be cross-examined.
