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Breech baby's parents tell inquest of delivery room 'panic'

Published 29/09/2015

Ipswich Hospital, where Bonnie Strachan died soon after her breech birth
Ipswich Hospital, where Bonnie Strachan died soon after her breech birth

The parents of a baby who died just moments after her breech birth have described the "utter panic" in the delivery room during labour.

Bonnie Strachan died at Ipswich Hospital on January 24 after being deprived of oxygen when she was delivered in an "extremely poor condition" in the breech position - meaning she was born feet rather than head first.

Her parents, Emma and James Strachan, from Framlingham, Suffolk, who have a two-year-old son called Percy, had decided against a caesarean section as is common practice for breech babies in the UK.

Giving evidence at an inquest in Ipswich, Mrs Strachan, 29, raised concerns about the advice they were given during pregnancy and a series of mistakes in labour.

She also said the delivery had not been taken seriously enough, with one midwife joking that the hospital could "sell tickets" for the unusual vaginal breech birth procedure.

Describing the delivery which took place on her own birthday, Mrs Strachan said: "We feel like our world has been turned upside down. Our baby girl was taken from us and Percy's little sister from him.

"The thought of a future pregnancy, labour and birth currently petrifies us."

She said the registrar responsible for the delivery had only delivered two breech babies previously and the latter moments of the delivery had been "panicked" and a "mad fumble".

After emerging feet first, the family felt Bonnie was "left hanging" for several minutes before Ms Kelly decided to release her arms and head.

When she was eventually delivered she was rushed to a resuscitation table but the oxygen ran out, Mrs Strachan said.

She added that staff seemed under-prepared for the delivery, for example not having the right sized forceps available.

The couple had also been told their baby was of average size but after birth it emerged she was larger than average which is an additional risk factor.

Earlier in the delivery, Mrs Strachan said the atmosphere had been "too relaxed", leading her to think the situation was not being treated with sufficient seriousness.

She added: "It was a jovial atmosphere. The midwife commented that everybody wanted to watch a vaginal breech delivery, saying 'We could sell tickets'.

"In many ways it seemed too relaxed. Looking back, at times I felt left alone while everybody around me was relaxed and jovial."

The inquest heard that Bonnie was born "pale and floppy" and could not be resuscitated despite doctors trying for 29 minutes.

Paediatric pathologist Zoe Mead said she found evidence of asphyxia and hypoxia associated with low oxygen levels.

She said Bonnie was larger than average and this, along with the breech position, were risk factors which could have contributed.

"Although there are risk factors it is difficult to know in this case what specifically caused the hypoxia which I thought was there," Dr Mead added.

The couple had considered a procedure to turn the baby during pregnancy.

However, after taking advice from a consultant, they decided against this because of the risks involved and the low chances of success.

They were also concerned about the complications associated with a caesarean, particularly as Mrs Strachan had suffered previous health problems including diabetes.

Mrs Strachan said they were informed that, because of the established practice of delivering breech babies by caesarean, many medics were not accustomed to performing vaginal breech births but they were reassured about the risks.

"We were told that if a vaginal breech birth wasn't progressing as expected a caesarean would be performed," Mrs Strachan said.

"We thought that this was a good option. We do not feel we had properly been made aware of the risks of a vaginal breech delivery."

A consultant, Andrew Leather, who knew the family and was an expert in breech deliveries had offered to attend but the offer was turned down, Mrs Strachan said.

Giving evidence, midwife Suzanne Kelly said she was aware of hospital guidelines which say a consultant should be present at vaginal breech deliveries.

The consultant was called to attend three times but did not arrive, she added.

The family has instructed medical negligence law firm Irwin Mitchell to represent them.

Coroner Peter Dean is expected to conclude the inquest on Wednesday.

Mr Leather told the inquest he would have been happy to attend the delivery had he been asked and was surprised his presence was not requested by the registrar.

"I did not specifically ask her how many breech deliveries she had done," he added.

In a statement read to the inquest, he said he had initially identified Mrs Strachan as a low-risk patient.

He had been happy with the couple's decision to go for a vaginal delivery despite the breech complication and did not ask about their reasoning.

Registrar Bethany Revell, who was in charge of the delivery, sobbed as she gave evidence.

She admitted she had not requested Mr Leather attend, saying: "I never said no but I never said yes."

Dr Revell said she identified the situation as an emergency as soon as she detected a low foetal heart rate.

She added: "The baby could have been delivered sooner but whether it would have changed the outcome, I don't know."

The inquest will resume on Wednesday.

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