Her unexpected death just 18 hours after the birth of a baby girl had nothing to do with her mother’s decision to have a natural birth, an inquiry has heard.
Abby Erin Blades died on January 16, 2019 at the National Maternity Hospital in Holes Street, Dublin, as a result of complications from her lungs and brain due to meconium (a baby’s first stool).
A meeting of the Dublin District Coroner’s Court heard that baby Erin’s mother, Louise Blades from Greystones, Ko Wicklow, wanted to have a natural birth and asked her to take advantage of an antenatal, Domino’s care service provided by community-based midwives. was also chosen.
Pathologist Paul Downey, who conducted the post-mortem of the girl’s body, said she had meconium aspiration syndrome – a condition when meconium gets into the lungs.
Dr Downey said baby Erin was born normal and had no birth defects, but was covered with thick black meconium and suffered a severe brain injury.
The pathologist acknowledged that it was not clear why this had happened.
While meconium can be normal in delivery, Dr. Downey said an additional problem with baby Erin was that it caused a narrowing of the blood vessels in the umbilical cord, reducing the amount of blood supplied to the baby.
He said the situation must have occurred at least 16 hours before the baby was born and before Ms. Blades arrived at the hospital.
Dr Downey said what happened was unrelated to the fact that Ms. Blades wanted a natural birth and did not want her membranes to be torn to facilitate the delivery.
The pathologist said he believed the bigger problem with meconium was its neurological effect rather than its effect on the baby’s lungs.
While there was also some failure of the placenta, Dr. Downey said he would have assumed it could have been the cause of a difficult labor but not such a catastrophic injury.
In an emotional statement, Ms Blades, who has three other children, recalled how Erin’s labor was at its best.
Ms. Blades said she wasn’t worried when she went to National Maternity Hospital after starting contractions, but added that it was “the calm before birth.”
She admitted that what happened after Erin was born was “a little hazy,” but believed her baby was all she needed help and that she would be fine.
However, she said that her husband, Stephen, had a different memory of the events and knew it was serious.
Ms Blades said she was disappointed before not being able to see and hold her daughter that Erin was very ill and “the outcome was not going to be good.”
He heard that his child had a seizure, but he was not in pain.
Fighting back tears, she commented: “I just wanted to be with him. I wanted to make good use of my limited time.”
Ms Blades outlined the final hours with their newborn daughter when the couple brought their two older sons, Ryan and Finn, to see their new sister and sing and read together and take family photos.
“We celebrated what we call Erin’s Day. The boys met their sister and we had a christening and a party,” she told interrogation.
Recalling baby Erin’s final moments after medical staff removed life support from her body, Ms. Blades said: “I fell asleep like she did in my arms.”
Inquiries yielded evidence from several medical staff that baby Erin was pale, unconscious, closing her eyes and struggling to breathe after delivery shortly after midnight on January 16, 2019.
A neonatal consultant, Lisa McCarthy, told Inquiry that about 1 in 5 full-term babies may have problems with meconium, but only 10% of these may experience meconium aspiration syndrome.
Dr McCarthy said the grade and quantity of meconium were important factors in determining the outcome of such cases but the mortality rate in this condition was 10-15 pc.
Teresa McCreery, community midwifery manager at the National Maternity Hospital, said Domino’s service provided in certain geographic areas to women who wanted either a home birth or a natural birth in a hospital was assessed as low risk. went.
Ms McCreery told the coroner, Claire Keane, that she did not believe that women using the Domino’s service received any different treatment to women who went to the hospital during pregnancy.
However, she said that since baby Erin’s death, Domino’s midwives had a mentor working with her.
Based on the evidence, Dr. Keane gave the verdict of death by natural causes.
While sympathizing with Erin’s parents, the coroner acknowledged that there were still questions about her death that remained unanswered.
Welcoming the verdict, Ms Blades, who later gave birth to a daughter, Orna (2), said she had always believed that Erin’s death was not linked to wanting a natural birth and was glad that medical evidence was available. This was confirmed by
“We would also like to thank all the medical staff at Halls Street and all the midwives who have supported us fully before and after Erin’s death,” he said.