Midwife made wrong call to move woman who died during birth, inquest hears

In an ongoing inquest examining the tragic death of Maria Hiune Pirihira Neho during childbirth, a midwife has acknowledged making a critical error in judgment regarding the movement of the 33-year-old woman following a seizure. The inquest, held in Hamilton, is investigating the circumstances surrounding Neho’s death and that of her unborn child in February 2023. The case has drawn significant attention due to the complex interplay between clinical decisions, communication of medical histories, and the limitations of accessing comprehensive patient records. Neho was 39 weeks pregnant when she experienced a seizure during labor at home. According to the midwife involved, who has requested name suppression, the decision to move Neho was based on the limited space available at the location. However, the midwife later admitted that she should have prioritized assessing the woman’s vital signs—specifically her breathing, airway, and circulation—before relocating her. This admission came during testimony before Coroner Ian Telford, who questioned the sequence of actions taken during the emergency situation. The midwife also revealed that the system used to manage patient notes and information did not integrate with general health records. As a result, midwives were required to visit the Waikato Hospital in person to access detailed medical histories. At the time of Neho’s labor, the midwife was aware that the patient had a history of seizures and had previously taken anti-seizure medication. However, she was not informed of a formal epilepsy diagnosis. With the benefit of hindsight, the midwife expressed regret that she had not delved deeper into Neho’s medical background and considered recommending a hospital birth instead of managing the delivery at home. Following the seizure, Neho went into cardiac arrest, prompting immediate attempts at resuscitation. She was then transported via ambulance to Waikato Hospital, where efforts continued to stabilize her condition for approximately an hour before she was declared deceased. The baby was delivered by emergency caesarean section, but both mother and child were pronounced dead shortly thereafter. Dr. Duncan Lamont, a pathologist testifying at the inquest, stated that Neho’s cause of death was a rupture of the uterus during labor, an occurrence described as unexpected and catastrophic. This finding adds another layer of complexity to the investigation, highlighting the potential risks associated with complications during childbirth that may not be immediately apparent even with prior knowledge of a patient’s medical conditions. Viviana Sim, another midwife present during the birth, shared insights into her professional experience. She noted that throughout her career, she had never needed to access hospital records directly. When she felt a patient had withheld crucial medical information, she typically referred them to an obstetrician. Sim emphasized that if she had known about Neho’s seizure history, she would have initiated a referral regardless of whether an epilepsy diagnosis was documented. Sim reflected on how this incident has influenced her approach to patient care. She now recognizes that individuals may not always disclose their complete medical history, reinforcing the importance of thorough assessments and proactive referrals when necessary. As the inquest continues, further testimonies from St John paramedics, hospital staff, and other relevant experts are anticipated. These contributions will provide additional perspectives on the chain of events leading up to Neho’s death and the measures taken in response to the emergency. The findings of the inquest could lead to recommendations aimed at improving protocols for handling high-risk pregnancies and ensuring better access to comprehensive patient records for healthcare providers. The outcome of this inquiry may influence future practices within the healthcare sector, particularly concerning the management of patients with complex medical backgrounds during childbirth.