At the end of January, I wrote a blog post about the case of Sue Rose, a British midwife who lost her license to practice due to a complaint from a client. Read the original post about the case here:
Today, there is more news from Britain. Susan Rose speaks out about what it is like to deal with shoulder dystocia and her experience of being disciplined by her professional licensing organization.
Shoulder dystocia and cord prolapse are the two complications in obstetrics that are unexpected and can result in a baby death if they can’t be resolved very quickly. It’s very rare to have a healthy, full term baby die in birth so these two complications are dreaded by practitioners. With shoulder dystocia, the baby must be out by the time that 8 minutes have elapsed because blood circulation to the head is cut off and the head is becoming more purple with every second that goes by. There is no time to transport and, even if you could transport, there isn’t anything different that would happen in the hospital than what can be done at home. Babies have died and have suffered Erb’s palsy (nerve damage) both in hospital and in the home with this complication. It’s no wonder that shoulder dystocia is known as “the nightmare of obstetrics”. I have heard of cases where doctors and hospital based nurse midwives have been sued for damages when a child is injured or dies from shoulder dystocia but I’ve never heard of an insured practitioner having their license removed after one of these cases.
Professional disciplinary committees often have their decisions overturned in courts of law. When standards of disclosure and proper representation are found to be lacking, a court will throw out these decisions for improper procedure. Many licensed individuals simply fold their tents and walk away from the profession after undergoing a disciplinary procedure. It takes a lot of money and a lot of fortitude to keep going in the system to keep a professional license.
One of my friends was brought before a nursing disciplinary committee because she was the most senior attendant at a planned homebirth. When the baby showed signs of distress, the nurse called an ambulance and transported. The baby died after arrival at the hospital and the hospital staff did everything they could to turn the parents against their homebirth caregivers. After my friend had her license revoked by the 3 woman disciplinary panel, she took her case to the B.C. Court of Appeal. She received a large money award for work time lost plus all her legal expenses and her license was re-instated by the Court.
What came to light in Court was that the nurses association had been in possession of a great deal of material that would have helped my friend’s case but they had never made it available to her. It seemed as if they just wanted to punish her for attending a homebirth.
Pursuing her case in Court was successful in the end but it took 3 years of her life. Her young family lived with that stress and both her parents died during that time. They never knew that their daughter had been acquitted by the courts. These personal costs are a large price to pay for a court decision that has now advanced the profession of nursing in our province. Other nurses now have the right to full disclosure before appearing before a disciplinary hearing because nurses before them would not accept being treated like criminals.
Instead of making all these wrong moves and making emotional decisions, midwifery organizations must study up on the history of other professional bodies. If a midwife is good enough to receive a license in the first place, she is worthy of being given some compassion when things go wrong.
Here is the reaction of a Dutch midwife to the story in today’s paper about Sue Rose:
Really sad story. But what I don’t understand is how and why it is
possible to strike a midwife off after one case.
I served 10 years on the complaints committee of the Dutch midwives union
and about half the complaints we dealt with are found to be grounded and
the other half not. Quite often a complaint about a midwife consists of
more than one part and, often enough, some parts are found lacking and
others not. But no one was struck off the register. A midwife, who was
found lacking severely, would get a warning first and very probably a
meeting with the inspector, but never just struck off like this.