Key Points

  • A child died three days after an unsupervised home birth.
  • The child died as a result of injuries received during and just after birth.
  • A coronial enquiry into the child's death took place.
  • The child's mother advised the coroner that she did not understand the risks involved.
  • The child's parents were urged not to give birth at home because the foetus was lying sideways in the womb and the mother had tested positive for hepatitis C.

Background

The child was born on 17 February 2015 at his parent's home near Nimbin in Northern New South Wales. The child was born breech (bottom first) and without medical assistance. The child was born not breathing and it took some time for effective resuscitation to occur.

The child was rushed to Royal Brisbane and Women's Hospital Intensive Care Nursery. The child was diagnosed as having suffered from hypoxic ischaemic encephalopathy and that his prospect of survival was minimal. He was pronounced dead on 19 February 2015.

The coroner heard that the child's parents were urged not to give birth at home because the foetus was lying sideways and the mother had tested positive for hepatitis C. The mother advised the coroner that she wanted to avoid going to a hospital due to hospitals being "full of sick people". She also advised the coroner that she trusted her husband, who had previously delivered five of his own children at home, and did not want a confrontation about where the baby would be born.

Findings

The investigation lead to two recommendations being made, being:

  • That the Royal Australian College of General Practitioners consider developing policy guidelines to assist and support its members in advising patients in relation to requests for nonhospital births. Consideration could be given to the "National Midwifery Guidelines for Consultation and Referral".
  • That the Northern NSW Local Health District consider implementing an information outreach program to local general practitioners about the services currently provided by Northern NSW Local Health District in relation to mothers wanting non-hospital births.

Conclusion

The circumstances of NA's death highlight the need for a mechanism being put in place to monitor pregnancies that occur outside the hospital system and for parents to be made aware of the risks associated in non-hospital births. The recommendations made by the coroner, if followed, should assist in this regard.

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