THE unexpected death of a baby girl just over 18 hours after she was born was unconnected to her mother’s decision to have a natural birth, an inquest has heard.
Baby Erin Blaides died at the National Maternity Hospital in Holles Street, Dublin on January 16, 2019 as a result of complications with her lungs and brain caused by meconium (a baby’s first faeces).
A sitting of Dublin District Coroner’s Court heard baby Erin’s mother, Louise Blaides, had wanted to have a natural birth and had also chosen to avail of the ante-natal, Domino care service provided by community-based midwives.
Paul Downey, a pathologist who conducted a post-mortem examination on the body of the baby girl, said she had suffered meconium aspiration syndrome – a condition when meconium gets into the lungs.
Dr Downey said baby Erin was normally formed and had no congenital disorder but was covered in thick dark meconium and had suffered a severe brain injury.
The pathologist admitted it was unclear exactly why it had happened.
While meconium can be normal in labour, Dr Downey said in baby Erin’s case there was the additional problem that it caused the blood vessels in the umbilical cord to contract, which reduced the amount of blood being supplied to the baby.
He said the condition would have occurred at least 16 hours before the baby was born and before Ms Blaides had arrived in the hospital.
Dr Downey said what happened was unrelated to the fact that Ms Blaides had wanted a natural birth and did not want her membranes to be ruptured to facilitate delivery.
The pathologist said he believed the bigger problem with the meconium was its neurological impact rather than its effect on the baby’s lungs.
While there was also some failure of the placenta, Dr Downey said he would have presumed it might cause a difficult labour but not such a catastrophic injury.
In an emotional statement, Ms Blaides, who has three other children, recalled how Erin’s labour had been the nicest one.
Ms Blaides, who comes from Greystones, Co Wicklow, said she was not worried when she went into the National Maternity Hospital after starting to have contractions but said it was “the calm before the birth”.
She admitted a lot of what happened after Erin was born was “a bit of a blur” but she believed her baby only needed help and she would be fine.
However, she said her husband, Stephen, had a different recollection of events and knew it was serious.
Ms Blaides said she had become frustrated at not being brought in to see her daughter and being able to hold her before she was informed that Erin was very sick and “the outcome was not going to be good”.
She heard her baby had suffered seizures but was not in pain.
Fighting back tears, she remarked: “I just wanted to be with her. I wanted to make the most of our limited time.”
Ms Blaides outlined the final hours with their newborn daughter as the couple brought in their two older sons, Ryan and Finn, to see their new sister and to sing and to read together and take family photographs.
“We celebrated what we called Erin’s Day. The boys met their sister and we had a christening and a party,” she told the inquest.
Recalling baby Erin’s final moments after medical staff removed life support from her body, Ms Blaides said: “I fell asleep as she died in my arms.”
The inquest heard evidence from several medical staff about how baby Erin was pale, unconscious with her eyes closed and struggling to breathe after being delivered shortly after midnight on January 16, 2019.
A neonatal consultant, Lisa McCarthy, told the inquest that around one in five full-term babies might have a problem with meconium, but of these only 10pc might experience meconium aspiration syndrome.
Dr McCarthy said the grade and quantity of meconium were important factors in determining the outcome of such cases but the condition had a mortality rate of 10-15pc.
Community midwife manager at the National Maternity Hospital, Teresa McCreery, said the Domino service was provided to women in certain geographical areas who wanted either a home birth or natural birth in hospital who were assessed as low risk.
Ms McCreery told the coroner, Clare Keane, that she did not believe women who used the Domino service got any different treatment to women who attended hospital during their pregnancy.
However, she said that since baby Erin’s death, Domino midwives had a consultant working with them.
Based on the evidence, Dr Keane returned a verdict of death by natural causes.
Offering her sympathy to Erin’s parents, the coroner acknowledged there were still some questions about her death that remained unanswered.
Welcoming the verdict, Ms Blaides, who subsequently gave birth to a daughter, Orna (2), said she always believed that Erin’s death was unconnected to wanting a natural birth and was pleased that it had been confirmed by the medical evidence.
“We also want to thank all the medical staff at Holles Street and all the midwives who have been fully supportive of us before and after Erin’s death,” she added.