James Ihaka is a Herald reporter based in Hamilton.

Midwife admits she was out of her depth

Casey Nathan and Hayden Tukiri.
Casey Nathan and Hayden Tukiri.

A young midwife has begrudgingly admitted she was out of her depth when a mother collapsed while trying to deliver her baby, an inquest has heard.

A coronial inquest into the 2012 deaths of Casey Nathan who died after giving birth to her baby son Kymani is continuing in Hamiton.

Kymani died two days after Ms Nathan when his life support was switched off on May 23.
The inquest this morning heard continued testimony from the lead maternity carer, who has interim name suppression and gave her evidence via a video link.

Under cross-examination, the woman conceded handing over control of the situation to another midwife with more experience after the 20-year-old fainted while in a birthing pool.

"She was calling the shots in this urgent situation, not you. Do you accept that ?" asked counsel assisting the coroner Chris Gudsell.

"I accept she was the most senior person in the room but I don't accept that I was not involved," she said.

"The reason for that is your skills at the time did not equip you to take control as a lead maternity carer would expected to do, didn't they ?" asked Mr Gudsell.

"I was also making suggestions, I was commenting on what was going on...we were working as a team."

Earlier the inquest heard how midwifery guidelines demanded a consultation with an obstetrician when it became obvious there were abnormalities with Kymani's delivery - but the midwife ignored these.

At one stage Kymani's heartbeat could not be heard for at least 22 minutes but this was not acted upon.

The midwife, who often gave rambling responses to questions and had to be asked the same query more than once, also defended her not calling a neonatal retrieval team sooner when it was apparent baby Kymani would require resuscitation upon arrival.

She stated her documenting of Ms Nathan's labour and Kymani's birth was not entire but "reasonable" given the circumstances - although she admitted some of her notes were completed "contemporaneously" .

She could not explain why she failed to record Kymani's heartbeat for long periods more than once.

The inquest also heard the woman did not check Ms Nathan's blood pressure, respiratory rate or pulse before she entered the birthing pool, nor did she document the event.

She said Ms Nathan's family were irritated by her prolonged labour and said the pool had helped with other whanau members in the past.

The midwife, who will continue giving evidence this afternoon, told coroner Garry Evans she had experience as lead maternity carer or as an assistant midwife in 35 births before Ms Nathan's.

The inquest, which is set down until Monday, still has more than half of its witnesses to give evidence.

- NZ Herald

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