A baby died of serious brain damage days after his delivery on a " chaotic" night in the delivery suite of Antrim Area Hospital, an inquest has heard.
Senior coroner John Leckey said it was concerning that a senior midwife in charge of the delivery suite stated that conditions on the night of Matthew White's birth were "chaotic".
A neo-natal team rushed to resuscitate the infant after he was born on November 3 last year, hours after his labour was induced. He died just days later.
Legal representatives of Matthew's parents Karen and David and the Northern Health and Social Services Trust said a neo-natal team should have been present in the delivery suite.
Consultant paediatrician Dr Sanjeev Bali told the inquest: "All was done that could have been done to save him from delivery to withdrawal of intensive care."
A post-mortem found that Matthew suffered brain damage but failed to find an underlying cause, which pathologist Dr Claire Thornton said could have occurred up to 10 days before his birth.
Karen White (30) from Steeple Road, Antrim, said she was 39 weeks pregnant when her labour was induced. She told the inquest that on her and her husband's arrival at the hospital, they were met by staff midwife Heather McComish.
The process of inducing labour began that night with the insertion of gels. Afterwards, Mrs White started to have what she described as "mild period pains".
She told the inquest: "It was not said that these were contractions.
"Staff midwife McComish told me they were gel pains and not to worry about them."
Later, as the pains got worse, she was given painkillers and a sleeping tablet. The pains intensified in the back and abdomen.
At around 6am, Ms McComish used a cardiotocography machine to monitor the baby's heartbeat, which found decelerations, or "dips". After an internal examination she told the mother she was four centimetres dilated, Mrs White told the court. She was taken to the delivery suite and dilated to 10 centimetres.
Ward sister Brigid Laverty, who was in charge of the delivery suite, told the court such rapid dilation was "uncommon".
She had been telephoned at 6.30am and told a patient who was induced was experiencing "decelerations" - but was not told that labour had started and the patient had dilated to 4cm.
"It would have been helpful if I had known that," she said.
Thomas Fitzpatrick, representing Dr and Mrs White, asked Ms Laverty if she recalled being asked by midwife Valerie Stewart to contact Dr Omar, consultant obstetric registrar.
She said she "did not recall" this. The ward sister said the night had been busy for the five midwives, including herself, who were on duty.
"They were working solidly from 8pm the night before without a break. Anything could have happened that night," she said.
Coroner Leckey said Ms Laverty's description of the delivery suite " suggested a very chaotic situation".
"I find Sister Laverty's agreement that this was chaotic, concerning," Mr Leckey said.