Inquiry hears that water births are an “experimental procedure”

Montrose Maternity Unit
Montrose Maternity Unit

Water births are an “experimental” procedure that should “only be performed within the context of a clinical trial”, an inquiry into the death of a baby who died after being born in a birthing pool was told today (Monday).

Nevaeh Stewart died just three-and-a-half hours after she was born at Montrose Royal Infirmary’s community midwife unit on September 30 2012.

A fatal accident inquiry into her death is being held at Forfar Sheriff Court - where her father, Gary Stewart, 30, of Auchenblae, Aberdeenshire, earlier described the unit as an “emergency response blackspot”.

That was after notes made by midwives showed they had noted a neonatal transport team as being “en-route” from Ninewells in Dundee at 5.40am - but didn’t arrive until 7.15am.

Today Dr Peter Fowlie, a consultant paediatrician and regional director of neonatal transport for NHS Tayside, told the inquiry that health boards do not have the resources to ensure a “flying squad” of medics can rush to community midwife units in case of an emergency.

He also said that “it is possible” that earlier intervention by specialist doctors may have saved Nevaeh’s life.

Dr Fowlie was first asked about the use of water births - an option offered across Scotland to pregnant women in hospitals, midwife units and for home births.

Fiscal depute Andrew Ramsay said: “There is a significant difference of opinion between experiences around the safety of water birth?”

Dr Fowlie said: “The debate still exists about whether it is safe for baby to be delivered in water.

“There is a reasonable body of evidence to suggest that labouring in water is potentially helpful to the mother.

“The evidence about delivering in water is still uncertain.

“There is ongoing difference of opinion about whether birth in the water is safe for the baby.”

Mr Ramsay said: “To quote an American study in your report, it says ‘Immersion during the second stage of labour has no proben benefit to mother and baby and can potentially have adverse, even fatal risks. The process of immersion during water delivery should be considered an experimental procedure and only carried out within the context of a clinical trial with informed consent.

“Is it the case that you support the view that I’ve read to you from the American study?”

Dr Fowlie replied: “Yes.”

Dr Fowlie also gave evidence on support for midwife units - which operate without doctors on site - in case of emergencies.

He said: “There is not enough resource to be able to guarantee that we can release staff immediately from neo natal units to CMUs.

“It requires a certain level of training and experience to undertake neo-natal transport medicine.

“There are some occasions where there are no neo natal staff available with experience of that.”

And speaking directly of Nevaeh’s tragic death, he said: “It is possible that earlier intervention might have altered the outcome.

“If support had been available sooner it is possible.

“But there are babies who are unexpectedly born in a compromised state across the UK and a small number of them, even if they were born in a facility with a neo-natal unit, would die.”