She was 41 weeks along when she went into labour in November 2006.
As planned she called her midwife.
Her labour was strong, and when her midwife arrived at her house she detected foetal heart sounds of between 140 and 158 beats per minute.
She trusted this midwife.
It was just as she wanted – in her home – a place of calm of peace.
A place of trust.
By 2pm she was fully dilated. Her soon to be born son’s head high.
For the next four-and-a-half hours she laboured.
The legal term, in the Supreme Court judgement, for this four-and-a-half hour period has been coined “protracted and complex”.
You can only imagine what the ‘non-legal’ phrases used would have been.
A protracted and complex labour ensued.
To stick with the legalese the “plaintiff’s head” (that would be the newborn baby) descended slowly and, apparently, in a variety of positions.
Louise Hall, covering this story for Fairfax, writes that he was delivered at 6pm, when “thick meconium was noted.”
Top Comments
The midwife may have acted negligently in not correctly informing the mother of the risks/benefits associated with a homebirth or in failing to attain transport to a hospital at an earlier stage when the labor "failed to progress".
However, the notion that Cerebral Palsy (CP) is largely caused during intrapartum hypoxia and that it is preventable is incorrect. More and more, recent studies have shown that the increase in emergency caesareans have done nothing to reduce the rates of CP. An eminent Adelaide professor and obstetrician has confirmed this in a recent meta analysis, see:
http://journals.lww.com/gre...
Thus, regardless of whatever negligence the midwife may have committed she almost certainly didn't cause the Cerebral Palsy. There is hypothermic treatment that can be used on neonates to reduce encephalopathy, but it's efficacy at reducing/preventing CP has yet to be established, so even if Khalsa had provided this in a timely fashion it would have been unlikely to do anything.
Instead the difficult and protracted birth was probably more a symptom of the earlier causes, such as infection during pregnancy or genetic abnormalities, that had compromised the placenta and this became evident once birth commenced.
Khalsa was uninsured for homebirth services as no insurer will provide insurance for homebirths due to the market failure that persists in actuarials having to look to legal risk rather than modern science (the legal community still thinking CP is preventable with our present technology). APRHA is somewhat alive to this insurance market failure issue and that is why there is a moratorium on the requirement for health professionals having insurance covering intrapartum homebirth services (all other health care professions require insurance for all aspects of their service).
Without insurance funding behind a defence, Khalsa, being a midwife who made a relatively meagre living supporting women in their right to chose a birth setting, could not afford to pay an expert witness to argue the above causation fallacy I have just set out. No wonder she saw she had no hope in court.
Self represented litigants never win. She panicked, she ran. Understandable. In no way a demon, just a midwife doing what she thought best for women and although I don't agree with advocating homebirths for high risk women or first time mothers I can understand how this all came to be.
Just to put a different spin on matters, we had a horrible experience with a Ob.. with our first child and 3 beautiful experiences with Akal who delivered 3 of our children at home.
This case is a real sham because Akal was ultra professional and provided wonderful care.
She definately had no insurance and this was because none was available. We knew she was uninsured.
Akal provided a great service to those of us that were failed by the system.
Its just horrible for this family that this injury happened.