The Health & Disability Commissioner has found a midwife breached the Code of Patient Rights in relation to the birth of a child.

The Commissioner found that the midwife failed to effectively communicate to the mother that the baby’s growth had slowed and failed to follow the recommended actions in such a situation.  The midwife failed to adequately communicate with the patient regarding transfer to hospital for the slow progress in labour.  The midwife referred to a doctor in the hospital in uncomplimentary abusive terms which put doubt in the patient’s mind and caused her to not follow the doctor’s recommendations.

The midwife failed to properly hand over care to the hospital upon transfer of the patient to hospital.  The midwife also did not communicate clearly that she supported a caesarean section, given the babies lack of progress.

The midwife also told the patient that a CTG was “really reassuring” and that the baby was “ok” when the CTG actually showed that the baby was deteriorating.  The midwife also failed to provide the patient with adequate notes during the pregnancy.

The hospital was also criticised for lack of clarity around the transfer of clinical responsibility from the midwife once the patient arrived at hospital and the communication to the patient about the need for a caesarean section.  The patient had declined a caesarean section on two occasions despite the urgings of the hospital doctors, because the midwife was supporting her desire to continue with a natural birth.

The Commissioner recommended that the midwife provide a letter of apology to the patient and that the findings be referred to the Midwifery Council for review of the midwife’s competence.

The Commissioner also recommended that the hospital review its protocol for transfer of patients from midwives to the hospital staff.




Alan Knowsley
Medical Lawyer
Wellington