‘Alanah was in a lot of pain’

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?’’