A MEDICAL expert has called for a ban on the routine use of water births after the death of a new-born baby girl.
Nevaeh Stewart died shortly after her mother gave birth to her in a birthing pool at Montrose Royal Infirmary’s community midwife unit on the morning of September 30, 2012.
Dr Peter Fowlie, a consultant paediatrician and regional director of neonatal transport at NHS Tayside, told a fatal accident inquiry into Nevaeh’s death that water births should only be carried out during clinical trials.
Read more: Rise in number of nursing and midwifery vacancies
It is currently offered as an option to pregnant women in hospitals, midwife units and for home births across Scotland.
Citing evidence from a US study about the widespread practice, he told Forfar Sheriff Court that there was a “reasonable body of evidence to suggest that labouring in water is potentially helpful to the mother”.
He was asked by fiscal depute Andrew Ramsay: “Is there a significant difference of opinion between experiences around the safety of water birth?”
Dr Fowlie replied: “The evidence about delivering in water is still uncertain. There is an ongoing difference of opinion about whether birth in the water is safe for the baby.”
He quoted the US study which stated that immersing a pregnant woman in water during the second stage of labour had no proven benefit.
Dr Fowlie added that the research highlighted how it could “potentially have adverse, even fatal, risks”.
He continued that the report stated that “immersion during water delivery should be considered an experimental procedure and only carried out within the context of a clinical trial with informed consent”.
Read more: Rise in number of nursing and midwifery vacancies
Asked by Mr Ramsay whether he supported that view, Dr Fowlie replied: “Yes.”
The expert also gave evidence on support for midwife units, which operate without doctors on site in case of emergencies.
Earlier, Nevaeh’s father, Gary Stewart, 30, of Auchenblae, Aberdeenshire, had described the unit as an “emergency response blackspot”.
Notes made by midwives showed they had noted a neonatal transport team as being “en route” from Ninewells in Dunadee at 5.40am, but it did not arrive until 7.15am.
He said: “There is not enough resource to be able to guarantee that we can release staff immediately from neonatal units to CMUs.
“It requires a certain level of training and experience to undertake neonatal transport medicine.
“There are some occasions where there are no neonatal staff available with experience of that.”
Dr Fowlie also said that it was “possible” that earlier intervention by specialist doctors may have saved Nevaeh’s life.
He said: “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 neonatal unit, would die.”
Read more: Rise in number of nursing and midwifery vacancies
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.”
The hearing continues.
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