An Auckland obstetrician has described his shock at a "cluster" of alleged errors made by a midwife.

The midwife is facing a disciplinary tribunal in Auckland on a charge of professional misconduct relating to the "horrific event".

Obstetrician Keith Allenby told the hearing the mother suffered "the most extensive and complex perineal tear" he had seen in 20 years of practice.

The charge, laid under the Health Practitioners Competence Assurance Act, was the midwife, known as "Ms P", acted in such a way that 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 the Health Practitioners Disciplinary Tribunal hearing yesterday, Dr Allenby, an obstetrician and gynecologist at Counties Manukau District Health Board said Ms Gutzewitz's tear was caused when 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 stitches 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.

Ms P's lawyer, Anita Miller, 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 impacted on her abilities to perform her duties as a midwife.

Ms Gutzewitz said that 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."

Her mother 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 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.

Dr Allenby demanded Ms P returned 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.