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Monitoring of established labour and fetal heart rate when meconium noted (03HDC15086)

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(03HDC15086, 24 February 2005)

Midwife ~ Prolonged labour ~ Monitoring of labour ~ Fetal heart rate ~ Baseline measurements ~ Pain relief ~ Transfer of care ~ Communication ~ Postnatal care ~ Standard of care ~ Rights 4(1), 4(2), 6(3)

A 30-year-old woman complained about the care provided by her midwife. The woman was expecting her first child, and wished to give birth in a maternity clinic rather than at a public hospital. When her labour became prolonged, she changed her mind and asked the midwife to transfer her from the clinic to the hospital. It took two-and-a-half hours for an ambulance to arrive after the midwife had accepted the woman's request for a transfer, but the baby was finally delivered at the hospital.

It was held that the midwife's management of the early labour met the required standards of care. However, she failed to record the woman's blood pressure, temperature and pulse at the beginning of established labour, and to adequately monitor the fetal heart rate after meconium was noted, which was unacceptable. The midwife failed to provide services with reasonable care and skill and in compliance with the standards expected of her profession, and breached Rights 4(1) and 4(2).

It was also held that the midwife breached Rights 4(1) and 6(3) in not ensuring a timely transfer of the woman to the hospital by ambulance, and not explaining why the delay had occurred.