A MIDWIFE with more than 20 years' experience has told how she had never seen any patient deteriorate as quickly as Savita Halappanavar.
Miriam Dunleavy, a staff midwife at St Monica's ward in University Hospital Galway, described Savita's deterioration as "frightening".
She told the inquest that the young 31-year-old dentist had been "one of the healthiest women on the ward" on the night of Tuesday, October 23, 2012.
Ms Dunleavy, a staff midwife at St Monica's ward at the hospital for more than seven years, gave evidence that Ms Halappanavar suffered a spontaneous rupture at 12.30am on Monday morning.
She told the inquest she did not inform any doctor of the spontaneous rupture because it was not a medical emergency. "This happens all the time on this ward," she added.
Ms Dunleavy said she had been aware that Ms Halappanavar's temperature was elevated when she returned to work on Tuesday night for night duty. However, she disagreed that Ms Halappanavar was in a serious condition at that stage.
"She would have been one of the better patients on the ward," she said.
Ms Dunleavy said that it had been a very busy night on the ward but insisted Ms Halappanavar had not been distressed.
The midwife gave evidence that, at 4.15am on Wednesday morning, Ms Halappanavar had called for assistance and requested a further blanket for herself and her husband, who was sleeping on the floor.
Placing the blanket over her, Ms Dunleavy noticed Ms Halappanavar shivering. She took her temperature – which was slightly elevated at 37.7degrees – and gave two paracetamol to bring it down.
Ms Dunleavy said Ms Halappanavar's deterioration on Wednesday morning between 4am and 6am had been rapid, saying it "frightened the two of us", referring to herself and her colleague, who was heavily pregnant at the time.
"I've never seen a woman with an inevitable miscarriage get so sick, so quickly on our ward in seven years," she added.
Ms Dunleavy said she had no recollection of checking the heater in Ms Halappanavar's room despite Praveen Halappanavar giving evidence to the contrary.
When asked how Ms Halappanavar looked at that stage, Ms Dunleavy answered: "She just looked tired, emotionally tired."
Earlier, a close friend of Savita's backed up her husband's claim that they had been told a termination was not possible because of the Catholic ethos of the country.
Mrudula Vasealli had been by her side on Tuesday, October 23, several days after she was admitted to hospital, while Praveen left to bring his wife's parents to the airport.
Ms Vasealli told the inquest that Savita had been told there was no way the baby could survive but the young woman could not bear to watch the foetal heartbeat while she waited for it to stop.
The inquest heard that both Savita and Mrs Vasealli had asked the midwife was it possible to save the baby as it still had a heartbeat after three days. Savita told the midwife that she could not take the waiting for the baby to die.
The midwife checked with the consultant if a stitch could be performed but returned and told Savita this was not possible because the membrane had bulged.
Savita then asked if there was any way the heartbeat could be stopped as the baby could not be saved but was told: "We don't do that here dear, it's a Catholic thing,, according to Mrs Vasealli.
Savita replied: "I understand you can't do anything but I can't stay like this."
While the midwife in question was not named, Declan Buckley, for the HSE, said he believed it to refer to clinical midwife manager Ann Maria Burke, who was accompanied that day by student midwife Elaine Finucane.
Both had made statements to the coroner, but neither refer to that statement "it's a Catholic thing" having been made.
Neither woman was due to be called as a witness but Dr McLoughlin requested both attend for the sake of completeness.