The title of this post is blunt, perhaps even shocking or offensive. But the ongoing situation wherein some New Zealand midwives demonstrate gross incompetence and babies die as a result is far more shocking and offensive than the title of this post could ever be. Note that I said ‘some’ – there are many good midwives around.
Before we look at the latest tragedy, suffered by Robert and Linda Barlow and their baby, a bit of history is in order. I cannot recall the precise date, but about 13 years ago the state’s system for paying GPs (family doctors) who delivered babies was changed. Basically the government told GPs that their services were no longer required, and the message was delivered by cutting their pay rates to a pittance. Mothers lost the continuity of care that a doctor they knew well could provide, while midwives became well paid Lead Maternity Carers (LMCs), handling uncomplicated deliveries without the oversight of a doctor. There has been a recurring problem of midwives not calling for help when a delivery becomes complicated, resulting in distress for mothers and, sometimes, death for babies. Why is this? Are midwives simply not trained well enough? The lack of monitoring of mother and baby that is usually associated with a death indicates a lack of training. A doctor has told me – on condition of anonymity – that midwifery is rife with extreme feminism. Are midwives fed a feminist agenda whilst training, an agenda that says “We can handle it, and there’s no need to call on paternalistic medical doctors”? Whatever the cause, the present system is clearly not working: that’s almost inevitable when the government runs health and free choice by mothers is limited or taken away.
I believe that the fundamental problem here is government control of health care, because history shows that incompetent people only flourish in state-controlled situations. When you want your car fixed, you ask around and find the best mechanic: in a free market those who provide the best service thrive, and those who don’t go out of business. It should be the same in health care. Sadly, New Zealand laws basically do not allow us to sue for damages; I believe that part of freedom is being able to obtain redress from those who harm us or our property.
Let’s look at the latest tragedy. The video below tells the story, but the following points from it are worth highlighting:
- Newly qualified midwives work alone as LMCs as soon as they are qualified. Linda Barlow, the mother in this story and a physiotherapist with above-average medical knowledge, said It’s unbelievable a lead maternity carer responsible for two people’s lives can be freshly out of college and independently in charge with no experienced experts alongside her (source). I entirely agree.
- Barlow had a previous difficult delivery. When her experienced midwife went on sick leave Barlow assumed that the replacement was equally experienced; in fact she had only been qualified for seven months. I do not wish to criticise Barlow, but assuming the competence of someone who has your life in their hands is dangerous. Ask someone how much experience they’ve had, and if they object to the question in any way run – don’t walk – away.
- Barlow was going to deliver in a maternity centre. My friends who have had many children insist on going to a major hospital, which is generally safer.
- After labour began Barlow went to the maternity centre and the midwife sent her home, despite Barlow pleading to stay and despite the fact that she was in labour and in severe pain. In my humble opinion this alone is enough to warrant severe disciplinary measures.
- When the midwife went to the home of Linda and Robert Barlow a few hours later Barlow was ready to deliver and the midwife called an ambulance to take her back to the birthing centre. The midwife did not take Barlow’s pulse and did not properly monitor the baby. Despite the fact that the midwife had not done the most basic checks on the status of her two patients, the ambulance was told not to use sirens (travel at speed). How could the midwife make that judgment call correctly when she didn’t have any supporting information?
- Later, when the situation was clearly serious another ambulance was called to take Barlow to hospital, and again the midwife told the ambulance crew that there was no need for sirens. Barlow says that there was no monitoring of her vital signs during this second visit to the birthing centre and monitoring of the baby was inadequate, so for a second time the midwife was telling an ambulance crew to dawdle along, despite the fact that she had little or no idea of how healthy her patients were. Speaking from experience, the first thing an ambulance crew does is check vital signs – it’s just common sense.
- Mother and baby were not monitored properly for an hour after they arrived at the hospital, at a time when both were dangerously unwell and declining. I do not know who was legally and morally responsible at this time, but this is clearly a serious matter. The Barlows may not have known how bad things were, but if you find yourself being ignored in hospital whilst dangerously unwell you must call the staff and state clearly your concerns. Grab a doctor if you have to; do whatever it takes to get attention from the overworked staff.
- Stuff mentions some of Barlow’s injuries: a stroke and a heart attack during the delivery and needed six minutes of CPR. She required 7.6 litres of blood transfusions. The average body has five litres of blood…respiratory failure, a heart attack, a stroke, psychological trauma, permanent bladder damage, mild brain damage and a hysterectomy. They don’t mention a ruptured uterus (womb) and a massive scar on her arm. The midwife took away Linda’s good health, her ability to have more children, and her baby’s life.
- The Barlows were told that their baby was still born, when in fact he showed signs of life. This sounds like the medical practice of 40 years ago.
Robert and Linda Barlow, I am very sorry to hear that you and your baby were treated so terribly. I hope that some change for good will come out of this.