‘Alanah was in a lot of pain’

Marlborough Express - - FRONT PAGE -

It was three days af­ter the birth when Alanah Gilder asked her part­ner Matt Steeghs what had hap­pened.

Gilder, then 20, had been rushed into surgery with un­con­trol­lable bleed­ing fol­low­ing the birth of her son Lu­cas. In Waikato Hos­pi­tal’s High De­pen­dency Unit after­wards, she asked staff not to tell her how bad it was.

But on day three, she had to know. Steeghs broke the news.

Her uterus had been re­moved to save her life.

It has taken more than three years for the first-time par­ents to get an an­swer to their next ques­tion: How did it all go so wrong?

Next week, the Health and Dis­abil­ity Com­mis­sioner (HDC) will make pub­lic its in­ves­ti­ga­tion into Lu­cas’ birth.

It finds Gilder’s mid­wife breached the Code of Health and Dis­abil­ity Ser­vices Con­sumer Rights for fail­ing to com­mu­ni­cate the need for Gilder to trans­fer from Hamil­ton’s Water­ford Birth Cen­tre to Waikato Hos­pi­tal dur­ing a pro­longed labour. This put her at risk of a post-par­tum haem­or­rhage.

It fur­ther crit­i­cises the birthing cen­tre’s mid­wife for her in­ac­tion, and Waikato District Health Board for not con­duct­ing an in­ter­nal review into Gilder’s emer­gency hys­terec­tomy, which was rare for a woman of her age.

Deputy Com­mis­sioner Rose Wall said the mid­wife, who Stuff has cho­sen not to name, did not abide by re­fer­ral guide­lines.

‘‘Ms Gilder should have been told that her progress was slow, the risks should slow progress con­tinue, the op­tions avail­able and, in par­tic­u­lar, the rec­om­men­da­tions for ob­stet­ric con­sul­ta­tion.’’

Wall has or­dered the mid­wife to apol­o­gise, and un­dergo fur­ther train­ing.

But the young cou­ple say their heart­break at not be­ing able to have an­other child has been ex­ac­er­bated by a lengthy process, dur­ing which their mid­wife faced no sanc­tions.

Their case comes as a new study finds only 10 per cent of New Zealand mothers who get se­verely ill dur­ing child­birth are of­fered ad­e­quate af­ter­care, in­clud­ing a de­brief, psy­cho­log­i­cal sup­port, and a fol­low-up.

Al­most half do not even re­ceive a dis­charge let­ter.

Gilder first laid her HDC com­plaint in March 2015. She fi­nally re­ceived the com­pleted in­ves­ti­ga­tion 25 months later – within two weeks of telling the HDC she had spo­ken to Stuff.

‘‘It’s al­most made it worse know­ing that my mid­wife made mis­takes. Things need to change,’’ Gilder says. ‘‘How could this be al­lowed to hap­pen? It’s pretty ridicu­lous, three years is a long time to make peo­ple wait. We might want to adopt one day but I couldn’t move past this un­til I knew what’s hap­pened. It’s put our lives at a stand­still.’’

Health and Dis­abil­ity Com­mis­sioner An­thony Hill apol­o­gised to Gilder for the length of time taken, say­ing three years was ‘‘never ac­cept­able’’.

‘‘It’s very rare, but I don’t think it’s ac­cept­able and I’m not try­ing to de­fend it.’’

A Waikato District Health Board spokes­woman said it ac­cepted the find­ings, and re­port­ing pro­cesses had been im­proved.

Gilder was hav­ing reg­u­lar con­trac­tions when she ar­rived at Water­ford Birth Cen­tre about 1pm on Au­gust 8, 2014. Her labour pro­gressed slowly, and the mid­wife ne­glected to check Gilder’s vi­tal signs.

In­de­pen­dent mid­wife Brid­get Kerkin said by 12.05am, there was a ‘‘sig­nif­i­cantly con­cern­ing lack of progress’’ and a grow­ing risk to mother and baby.

But Steeghs said they had no idea Gilder’s labour was ab­nor­mal. ‘‘There was never any sense that we needed to leave, there was no ur­gency. At the same time there was no ev­i­dence that he was com­ing out, and Alanah was in a lot of pain.’’

Steeghs said the cou­ple fi­nally asked to be trans­ferred. They ar­rived at Waikato Hos­pi­tal at 5.10am, where doc­tors tried a vac­uum-as­sisted de­liv­ery, aban­doned af­ter two pulls.

Lu­cas was born by emer­gency cae­sarean sec­tion, but Gilder suf­fered a mas­sive post-par­tum haem­or­rhage and a hys­terec­tomy was per­formed. She lost 4 litres of blood.

Gravely ill, Gilder re­mained in hos­pi­tal for a week.

‘‘At the time I was so shocked with ev­ery­thing that had hap­pened, and I had a new baby to look af­ter. It’s quite hard to know that I can’t have any more kids.’’

For Steeghs, the past few years have been marred by dis­be­lief. ‘‘You’re just think­ing ‘How the f... can some­thing go so wrong?’’

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