Home births – Health Care Complaints Commission v MacGregor

PUBLISHED 18 Oct 2016

A recent decision by the Health Care Complaints Commission (HCCC), found that a midwife’s registration be cancelled and she be disqualified from reapplying for re-registration for 3 years.

Ms MacGregor provided care and treatment as a midwife to a patient from about 27 November 2013 until 19 May 2014. Patient A had a past obstetric history of two pregnancies with two births both significantly requiring Caesarean sections performed in hospitals due to a failure to induce labour at 41 weeks of gestation. This history called into question the safety of Patient A having a home birth.

On 18 May 2014 things were not right and Ms MacGregor failed to advise patient that she should be seen by a medical practitioner. The patient had been experiencing two weeks of irregular but ongoing painful contractions. During this period she was mostly in phone contact with Ms Macgregor.

The following day, the patient presented at St George Hospital with regular contractions every 6 minutes but the patient had not felt any fetal movement for 12 hours prior to presentation.

On arrival at the Hospital, no fetal heart rate was detected and the Obstetric team confirmed that the baby had died. A Caesarean Section was performed and the deceased infant was delivered.

It was argued before the Commission that Ms MacGregor was guilty of unsatisfactory professional conduct and professional misconduct such that the demonstrated knowledge skill or judgement, or care exercised, by Ms MacGregor fell significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience.

In more detail, it was argued that Ms McGregor failed to:

  • consult with medical and professional health staff about the patient resulting in inadequate advice being given;
  • obtain an adequate history;
  • document advice given to the patient about the safety and risk involved;
  • provide correct advice;
  • inform the patient about changes to the health and well-being of her and her baby;
  • provide an adequate care plan and collaborate with either a medical practitioner given the history of two prior caesarean sections;
  • advise that her care should be transferred to a medical practitioner on 198 May 2014; and
  • have a management plan for the patient’s home birth and a plan for management of an emergency.

Ms MacGregor admitted that she failed to properly advise her patient that her history of two previous caesarean sections meant a home birth was not recommended and that she should have strongly advised her patient to transfer to a hospital for the birth.

Further, it was found that the patient by 18 May was beyond 42 weeks of gestation and under acceptable standards of care should have been warned of the risks of a home birth. Ms MacGregor had incorrectly estimated the due date and did not revise it despite her date being at odds with the previous ultrasounds which placed this date in April.

Taken as a whole, Ms MacGregor’s conduct amounted to a serious breach of the level of care people have a right to expect from someone in Ms MacGregor’s position.

If you have had a similar experience, you might be entitled to compensation. Whilst nothing can replace the life of a child, compensation can go some way in assisting to lift the burden experienced around these events.

Call us now on 1800 004 878 to book a free appointment with one of my compensation experts, or email your enquiry.