Caroline Lovell died in 2012 after giving birth at home. The midwives who assisted a Melbourne mother who died after a home birth should have better sought medical history which showed she suffered a haemorrhage during her first pregnancy, an inquest has heard.
But the inquest into the death of Caroline Lovell also heard that midwives often faced difficulties within the health sector in accessing the medical records of their clients.
A panel of experts who reviewed the case of Ms Lovell, who became unresponsive about an hour after giving birth to a healthy girl on January 23, 2012 and died later that night, agreed in the Coroners Court the two midwives who helped deliver the second baby should have known the full extent of the mother’s previous postpartum haemorrhage.
The inquest has heard Ms Lovell experienced a postpartum haemorrhage in the birth of her first child in Geelong Hospital in 2008.
But midwives Gaye Demanuele and Melody Bourne, who delivered the second baby at Ms Lovell’s Watsonia home, did not have that information, the inquest has been told.
The court has heard Ms Lovell, 36, most likely died from a postpartum haemorrhage. An obstetrician at the Austin Hospital estimated she had lost three litres of blood.
A panel comprising Susan McDonald, a professor of midwifery at La Trobe University and the Mercy Hospital for Women; Rachel Reed, a lecturer in midwifery from the University of the Sunshine Coast; and Joy Johnston, a midwife of more than 40 years’ experience, told the court on Thursday that Ms Lovell’s midwives should have been armed with her medical history.
Professor McDonald said it was important for midwives to have a client’s complete medical history, as they could not always rely on the woman’s recall for accuracy. “Having accurate information is very important,” she said.
But Ms Johnston said midwives in private practice often found it difficult to access a client’s medical records from hospitals, and that they needed to gain the authority of patients to do so. Getting that authority required filling in forms and took time, she said.
Ms Johnston said in an “ideal world” midwives would be able to get the information efficiently, but often they struggled for professional recognition among the health sector. “I would like to see that happen … perhaps that’s something we could work on as a profession,” she said.
The inquest has heard Ms Lovell was encouraged by Ms Demanuele to undergo blood testing at 36 weeks but declined to do so.
Dr Reed said it was difficult for midwives to coerce clients into something they did not want to do.
Coroner Peter White asked what obligations midwives faced in regard to unborn children when their mothers declined suggestions, but Dr Reed said midwives were obliged to put maternal rights ahead of foetal rights.
A change in that principle would create a legal “slippery slope”, she said.
Earlier on Thursday, Ms Demanuele told Mr White she “absolutely” tested Ms Lovell’s blood pressure and had the equipment to do so once the mother’s health deteriorated.
Ambulance paramedic Marie Daley told the inquest on Wednesday that the midwives had reported to her at the Lovells’ home that they did not have the equipment and did not take her blood pressure.
The inquest continues.