No mother should ever die at homebirth.
Maternal deaths in the hospital are unusual; perinatal deaths are 100 times more common. There are so few maternal deaths in the developed world that they are measured per 100,000 and most of the women who die have serious medical complications like cardiac disease or pre-existing medical conditions. Death from a routine childbirth complication like bleeding is almost unheard of in an age of blood transfusions and surgical repair.
That’s why it’s horrifying to consider the latest report of a maternal death at homebirth. This marks the 4th publicly reported maternal death at homebirth in the past 4 years. All 4 women were in excellent health prior to childbirth and at least 3 (possibly 4) out of 4 simply bled to death.
Joanne Whale bled to death in 2008 as a result of a uterine eversion. Her midwife did not even know how to start an IV.
Sara Hedgepeth Osceola, mother of 6 small children, bled to death while attempting a VBAC at home.
Caroline Lovell, a homebirth activist, died shortly after she gave birth to her daughter.
Now comes word that Claire Teague bled to death due to retained placenta while the midwife went home.
According to the Mail Online:
A mother died within hours of giving birth at home after a private midwife committed a horrifying catalogue of errors, an inquest heard.
Claire Teague, 29, was left bleeding in bed after Rosie Kacary allegedly pulled out her placenta following the delivery.
The midwife is also accused of failing to realise a large section of the placenta had not come out and not stitching a tear.
Mrs Teague complained to her husband, Simon, about feeling weak and in pain after the birth but Kacary left and only returned after ‘repeated contact’.
When she came back to the couple’s home in Woodley, near Reading, Berkshire, she discovered Mrs Teague had stopped breathing.
Instead of performing CPR on a firm area such as the floor, Kacary is said to have done it on the bed, where it was less effective…
The midwife left at 10am. Mr Teague claimed that when she eventually returned and attempted to resuscitate his wife, she ‘didn’t seem to know what she was doing’.
The inquest heard from a paramedic who described the ambulance that took Mrs Teague to the Royal Berkshire Hospital as ‘swimming in blood’.
Doctors established around a third of the placenta – measuring 8in by 3in – had not been delivered.
Kacary believes that she did nothing wrong and (the classic excuse of the homebirth midwife) the patient would not have accepted advice to transfer.
She believed the placenta had been complete and said, if she thought otherwise, she would have advised an immediate hospital transfer.
But she said: “As Claire felt completely well at the time, I’m very sure they would have declined my suggestion to transfer.”
Why did Claire Teague die?
A post mortem found that Mrs Teague died due to a lack of oxygen caused by the severe haemorrhage due to a recent vaginal birth with a retained placenta.
But, according to Kacary, at least she had a great birth!
“Claire had a great pregnancy, she had a really lovely spontaneous birth at home and I hope Simon in time will remember that.”
Because when it is all said and done, for a homebirth midwife, it’s all about the process, and death is a small price to pay for a great birth experience.