The importance of comprehensive postnatal care and
support, and the difficulties that can arise when aspects
are lacking were highlighted in a decision by Deputy
Commissioner Rose Wall, who found a midwife in breach of the
Code of Health and Disability Services Consumers’ Rights
(the Code).
In her decision, Ms Wall found the midwife
failed to provide a woman and her new-born baby services
with reasonable care and skill. She also emphasised the
significance of comprehensive record-keeping, and the role
of handover at the end of service provision, to maintain
continuity of care.
A woman, living in a more rural
locality, who was pregnant with her first child engaged a
self-employed registered midwife as her lead maternity
carer. There were particular challenges for the midwife as
she was working beyond her normal geographical
area.
This case focused on lapses in the postnatal
care provided to the woman and her new-born baby by the
midwife. Unfortunately the midwife did not provide the
anticipated number of postnatal consultations to the woman
in the period following her C-section. As a result,
relatively common problems that can develop for women and
new-born babies in such circumstances were not appropriately
managed.
Ms Wall highlighted her significant concerns
about aspects of the care provided by the midwife, including
failures to store patient notes adequately; provide the
appropriate number of postnatal visits to the woman; assess
and manage the baby’s reflux and colic; adequately treat
the woman’s mastitis, and failing to discharge or refer
the woman to appropriate services at the end of the
postnatal period.
Ms Wall recommended that the
Midwifery Council of New Zealand (NZCOM) consider whether a
review of the midwife’s competence was warranted. She also
recommended the midwife provide a written apology to the
woman, complete an NZCOM record-keeping course for midwives,
and make a number of changes to her clinical practice in
relation to record-keeping, communication and follow up
procedures.
“Complaints offer a valuable learning
opportunity for health care professionals – they lead to
positive change and improved service delivery for future
consumers. I am pleased to see the midwife has made changes
to her practice and undergone further training,” says Ms
Wall.
Notes
This case relates to a complaint
made to HDC in 2020. We aim to investigate complaints as
promptly as possible, while ensuring natural justice and the
interests of all the parties involved to provide
information, and respond to evidence put forward by others
is considered.
The f ull
report of this case can be viewed on HDC’s website –
see HDC’s ‘ Latest
Decisions‘.
Names have been removed from the
report to protect privacy of the individuals involved in
this case.
We anticipate that the Commissioner will
name providers found in breach of the Code, unless it would
not be in the public interest, or would unfairly compromise
the privacy interests of an individual provider or a
consumer.
More information for the media and HDC’s
naming policy can be found on our website here.
HDC
promotes and protects the rights of people using health and
disability services as set out in the Code
of Health and Disability Services Consumers’ Rights (the
Code).
HDC acknowledges the significant pressure the
health and disability system is currently under with limited
capacity to respond to the demands placed upon it. However,
notwithstanding these challenges, people’s rights under
the Code continue to
apply.
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