Home birth tragedy

Prolapsed cord

Carrying on the debate about home births, Dr Crippen has his attention drawn to an article in the Daily Telegraph written by an experienced midwife, Traci Relph, who tragically lost a baby during a failed home delivery.

I do not normally comment on real cases. But this midwife has chosen to go public with her experience and to use it to justify her continuing belief in home births.

It is therefore fair to comment, and to put the other side of the argument.

In particular, Traci says her baby:

“…would not have been saved even if I had given birth in a hospital”

I know it may be a comfort to say that. I am sorry to cause upset. But this statement is made in a national newspaper to a wide and impressionable audience. It is not true. This baby was in grave danger but might well have been saved had the birth taken place in hospital.

Let us consider the facts.

“Two-o'clock in the morning, and I was in the late stages of labour with a midwife struggling to save the life of my baby boy as an ambulance rushed us through the deserted streets of south London to Lewisham Hospital.

I was seven centimetres dilated and she had pushed her hand right up into my vagina, trying in vain to keep his head from crushing the umbilical cord carrying oxygen to his brain.

She kept her hand there for 56 minutes, even as I was being wheeled at high speed along the corridor into theatre, and right up until the moment my baby was lifted up and delivered by Caesarean”

As I said in the original post, poor old Tom Reynolds has to try to pick up the pieces. I am sure the ambulance service did their best, but they do not have the equipment to deal with this sort of emergency. You need an operating theatre.

And you do not have 56 minutes to find one.

Traci continues:

“That was in June 2001 and I was 37 years old, a mother of three who was part-way through midwifery training. But nothing could have prepared me for the trauma of a home birth that went horribly wrong.

Earlier in the evening, as the first contractions had begun, I'd been laughing and joking with my in-laws and friends. Having had two home births already, I felt fairly laid back and comfortable in my own environment, and Simon, head of marketing in a graphic design division, was equally relaxed. We had no idea of the nightmare that would ensue in the early hours.”

This was a relatively elderly mother in her fourth pregnancy. Cord prolapses are rare, but they are 60% more likely to occur in multiparous women. Read about this in detail here.

Look at four of Traci’s comments:

• Earlier in the evening, as the first contractions had begun, I'd been laughing and joking with my in-laws and friends.
  
  
• Having had two home births already, I felt fairly laid back and comfortable in my own environment
  
  
• We had no idea of the nightmare that would ensue in the early hours.
  
  
• But nothing could have prepared me for the trauma of a home birth that went horribly wrong.

There are no guarantees in obstetrics. You can never predict what will happen, however experienced you are in obstetrics, and however many previously normal births a mother has had.

If you have a prolapsed cord, you do not have 56 minutes to spare.

This was a tragedy.

In my view, a tragedy that could have been avoided. It is proof positive of the dangers of home births.

The full article in the Daily Telegraph may be read here.

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Would anyone wishing to comment on this article, please do so under the original post, “Home delivery lunacy” which can be found here.