Caesarean flight fuels Kaitaia Hospital row

By TONY GEE

A three-hour wait for a pregnant Far North woman to receive an emergency caesarean operation in Whangarei has highlighted problems caused by the ban on caesareans at Kaitaia Hospital.

The woman, who had serious birth complications, had to be flown to Whangarei Hospital despite specialist staff who could have performed the operation being on hand in Kaitaia.

Kaitaia Maternity Services clinical manager Stephanie Getty said yesterday that the woman did not know if her baby was alive or dead when she boarded the helicopter.

"The mother could have haemorrhaged during the chopper flight," she said.

"The midwife on board wouldn't have been able to treat her and you'd have had a dead mother and baby."

But Northland Health spokesman Luke Worth defended the decision to transfer the woman to Whangarei.

"Clinically, the right decision was made to transfer these two patients [mother and baby] because to do so after the operation would have been extremely dangerous," he said.

"The baby needed emergency specialist paediatric intervention when it was born in Whangarei and the mother had required specialist obstetric care. Neither of these are available in Kaitaia."

The incident occurred last Wednesday morning, outside the hours of a Northland District Health Board ban on after-hours acute surgery at Kaitaia.

Caesareans at the hospital also stopped late last month when surgeons there were told they did not have the credentials to perform the operations.

Mrs Getty said the woman, in her twenties, "arrived on our [hospital] doorstep" at 7.20am in an acute obstetric emergency.

She was suffering an ante-partum haemorrhage, in which part of the placenta comes off the wall of the womb, putting both mother and baby in danger.

The woman was visibly bleeding.

"We could have had the operation here and got the baby out in 40 minutes by 8.30am," Mrs Getty said.

"We had a surgeon and specialist anaesthetist available and standing by, but we followed the new protocol and phoned the obstetrician in Whangarei."

The woman's condition was stabilised and Kaitaia staff were told to wait for the helicopter to arrive. It landed in Kaitaia soon after 9am and took off with the patient at 9.35. She was admitted to Whangarei Hospital soon after 10am and the baby, understood to be a girl, was delivered just before 11am while the mother was under a general anaesthetic.

Mrs Getty said the baby had suffered a degree of oxygen deprivation but a brain scan showed nothing abnormal at present and she was "progressing favourably". The mother was also well.

"If we'd done it [the caesarean] in Kaitaia, the baby's long-term prognosis would have been much better."

Kaitaia Hospital handles about 300 births a year, between 35 and 40 of which are caesareans, which now have to be performed in Whangarei.

Mr Worth said the family of the mother had told Northland Health "they did not want to be involved in a media debate" about Kaitaia Hospital.

"There's a trust relationship between medical caregivers and their patients, but in this case, patient rights have been broken because of personal agendas of people who run to the media. I'm appalled that medical professionals continue to go to the media."

Mr Worth said spcialist staff in Whangarei were available at any time to discuss clinical emergency situations and outcomes.

He said the clinically correct decision had been made to transfer the mother and baby to Whangarei.

The board and Northland Health are awaiting completion of a review for the Ministry of Health about the situation at Kaitaia Hospital, including after-hours surgery and caesarean operations. The review is due to be finished by the end of this month.

Robin Shepherd, a spokesman for the Vision Far North group which campaigns to maintain community services in the district, is calling on Health Minister Annette King to reinstate full services at the hospital and begin an immediate inquiry into the actions of the district health board.

Mr Shepherd said the three-hour delay in delivering the baby was unnecessary because a surgeon was ready and able to perform the operation.

"The situation is an absolute scandal," he said.

"Only a full independent inquiry will reveal the truth behind the board's actions."