Decision Report 201508111

Summary

Miss C's baby was not lying properly, but was in the breech position (legs downward). After unsuccessful attempts to turn the baby, she was booked in for a caesarean section (an operation to deliver a baby which involves cutting the front of the abdomen and womb). However, several days before the planned caesarean, Miss C began experiencing labour pains and called Ayrshire Maternity Unit. She was asked to come in and was reviewed, then sent back home. Two days later she called again and was asked to come in. Miss C was then admitted and monitored on the ward. She was reviewed by a doctor on several occasions, but told she was not in active labour and a caesarean was planned for the following morning. However, Miss C continued to experience symptoms and a consultant reviewed her and found she was in active labour. Miss C was sent immediately to the labour suite, where her baby was born a few minutes later. Miss C complained about the advice she was given on the phone and the management of the birth, in particular that staff did not recognise that she was in labour and arrange an emergency caesarean.

Staff from the board met with Miss C to discuss her complaint. They explained that when she was examined by the first doctor her cervix was closed, which meant that she was not in active labour. They also explained that, because Miss C's baby was under 39 weeks, the doctor wanted to prescribe steroids and allow time for these to work before conducting a caesarean (to decrease the risk of breathing problems for the baby).

After taking independent obstetric and midwifery advice, we did not uphold Miss C's complaint. We found that Miss C experienced rapid labour, which could not have been predicted by staff, and the care and treatment was reasonable in light of the circumstances known to staff at the time.