Case study: Stillbirth following negligent midwifery care
Case details
Isabel Harper, Associate in our Medical Negligence team settled a clinical negligence claim against Salisbury NHS Foundation Trust in July 2024. The claim arose from the treatment provided to a first time Mum during her pregnancy, which sadly led to the stillbirth of her daughter as a result of failures to identify that the baby was Intrauterine Growth Restricted.
This was the Claimant’s first pregnancy and she was assessed as low risk at the time of booking and allocated to routine midwifery care.
Case overview
The 12 week and 20 week scans were reported as normal. It was noted that the placenta was anterior. No concerns about the baby’s growth were identified.
During a routine midwifery appointment at 21+1 weeks it was noted that fetal movements had been felt but not regularly. She was advised to monitor from 26 weeks and to seek further advice if concerned. By 28+1 weeks, it was noted that fetal movements were getting stronger but not in a regular pattern yet. The Claimant was advised to monitor and to contact the labour ward if a pattern didn’t establish itself.
At 33+2 weeks, the Claimant telephoned the Labour Ward Triage, reporting a change in fetal movements and she was advised to attend for a CTG. Observations were in the expected range, the CTG was normal and the Claimant was discharged home.
At 34+1 weeks, the Claimant had a midwife appointment, when it was noted that the Claimant wasn’t feeling movements but that was normal for baby and that this may be due to the Claimant’s anterior placenta.
At 37+3 weeks, the Claimant telephoned Labour Ward Triage complaining of a headache and tightenings. The documented plan in the records was noted to be “Attend triage” but an investigation carried out by Healthcare Safety Investigation Branch (“HSIB”) found that the Claimant was not in fact told to attend maternity triage on this occasion and she was instead advised to call back if there was a change in baby’s movements or if she was worried.
The following day, the Claimant telephoned Labour Ward Triage again reporting an increase in pain and contractions and was advised to attend the Day Assessment Unit (DAU). Sadly, upon arrival no heartbeat could be detected on ultrasound.
The Claimant’s daughter was stillborn following an induction of labour later that day.
Negligence
Post-mortem examination found that baby’s measurements were smaller than expected for the gestation and her weight was lower than expected for these measurements. The placenta was small and showed features of ‘maternal vascular malperfusion’. These features were reported as baby being Intrauterine Growth Restricted (IUGR).
The Defendant Trust admitted that when the Claimant attended the Day Assessment Unit at 33+2 weeks, they breached their duty of care by failing to carry out a serial fundal height assessment. They admitted that the Claimant should have been referred for a growth ultrasound scan and had the Claimant been referred for ultrasound, it is likely that fetal growth would have been at the lower end of the normal range. It is likely that a further scan would have been requested 2 weeks thereafter.
Had the Claimant undergone a further ultrasound scan, it is likely that the scan would have shown a discernible fall-off in fetal growth. These findings would have led to increased fetal surveillance with twice weekly CTG traces and weekly Doppler blood flow and liquor volume estimations. It is likely that the scan a week later would have shown further reduction in liquor volume and abnormal Doppler flow studies, leading to delivery straightaway. It was admitted that scans would have identified the worsening situation, leading to an earlier delivery and the baby’s death would have been avoided.
An early Letter of Notification was sent to the Defendant seeking their admission of liability based on the failings identified in the HSIB report. However, other than the initial acknowledgment letter, the Defendant did not engage with the claim at all. We therefore proceeded to obtain full liability expert evidence from an expert Midwife and an Obstetrician and a Letter of Claim was sent. The Letter of Response admitting liability was received some 13 months after sending the Letter of Claim.
Case outcome
The claim settled in July 2024 for £65,000, the damages included an element for psychological injuries that the Claimant suffered as a result of losing her baby. The claim also included private costs for a Doula in a future pregnancy, and private antenatal costs.
Contact a specialist clinical negligence solicitor
If you have suffered the loss of a baby and have concerns about the care that you received, please call 0800 316 8892 or get in touch online for a free, no-obligation consultation with a specialist injury solicitor.
Charities including The Lily Mae Foundation and Sands provide support to parents and families who have suffered baby loss. We’re proud to support the work they do.
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