13. Mrs K complains the Trust should not have sent her home when she attended the Trust. She says the Trust did not listen when she told it of her previous rapid delivery and it did not take the downward pressure she was experiencing into account.
14. The Trust said its assessment of Mrs K showed she was in the latent stage of labour. (This the stage before established labour begins, when the cervix starts to soften and open so the baby can be born). It recommended Mrs K return home so she could be more comfortable. The Trust apologised and said it should have taken Mrs K’s history into account and said if it had, her birth experience could have been avoided. It said it now offers all women in the latent stages of labour the opportunity to be admitted to its birthing unit.
15. NICE guidelines say a woman is in the latent stage of labour when there are painful contractions and there is some cervical change including cervical effacement and dilation up to 4cm. A woman is in established labour when there are regular painful contractions and there is progressive cervical dilation from 4cm.
16. NICE guidelines also say If a woman presents with painful contractions, but is not in established labour, clinicians should encourage her to return home. This is unless doing so leads to significant risk that she could give birth without a midwife present or become distressed.
17. The Trust’s assessment showed Mrs K was experiencing contractions, she was 2cm dilated and 50% effaced. We think the Trust’s assessment of Mrs K being in the latent stage of labour was in line with NICE guidelines.
18. The records show the Trust had noted Mrs K was ‘worried as had rapid delivery in assessment room with second baby’. Our adviser said this, along with the fact Mrs K was experiencing downward pressure in her pelvis, indicating the baby’s head was engaged, were red flags. They said as Mrs K had experienced a previous rapid birth, the Trust should have considered this baby could be rapid too.
19. We consider this to be an indication of a failing. The Trust did not consider the risk to Mrs K of returning home, given her history of rapid delivery, in line with NICE guidelines. This means it did not consider Mrs K was at risk of giving birth without a midwife present.
20. We acknowledge Mrs K gave birth at home two and a half hours after she returned home, and without a midwife being present. We acknowledge how distressing this was for Mrs K and how it impacted her following the birth of her baby. She has told us how she needed to replace furniture and other home items following the birth, instead of focussing on her baby.
21. Our Principles for Remedy explain when things go wrong, we expect organisations to apologise and acknowledge responsibility. They also say organisations should take remedial action to prevent the same thing from happening again. This can include revising procedures to prevent the same thing from happening again, and train or supervise their staff.
22. We can see the Trust apologised to Mrs K and took steps to improve its service to prevent this issue from happening again. These actions are in line with our Principles. However, we do not consider the Trust has done enough to put the impact right for Mrs K.
23. Our Principles for Remedy say where poor service has led to an injustice or hardship, organisations should offer a remedy that returns the affected person in the position they would have otherwise been. When this is not possible, they should compensate them accordingly, which may include making a financial payment for direct financial loss, or in recognition of an emotional impact.
24. As set out above, Mrs K told us the Trust’s failure to allow her to remain in hospital meant items of her property were destroyed due to giving birth at home. We have considered Mrs K’s view the Trust should compensate her for these items.
25. Mrs K provided us with screenshots of online purchases for a mattress, a mattress topper and a rug doctor. All three items were undated except the mattress which was dated as November with no year specified. Mrs K was unable to provide us with evidence of the dates she purchased these items. Mrs K also provided us with email confirmation for a gift card she purchased for a carpet store, dated November 2022. She does not have a receipt for the carpet she purchased.
26. Given the circumstances of Mrs K’s labour, we think it is more likely than not she would have purchased the items she says she did. We asked Mrs K if she could have claimed for these items on her home insurance. Mrs K said although she could have claimed for them, she did not as this would have raised her premiums.
27. We have considered this. We think it would have been reasonable for Mrs K to claim for the damaged items on her home insurance, given this is a practical and established way of addressing property loss. Therefore, as Mrs K had an alternative way of replacing these items, we are not persuaded it is reasonable for the Trust to cover the cost of these items.
28. We do however, think the emotional impact of the Trust’s failing here is an injustice that has not been put right.
29. To consider a level of financial remedy, we consider our severity of injustice scale (SOI) and review similar cases. Level three of our SOI scale includes cases where the affected person has experienced a moderate impact such as distress and inconvenience. It also includes cases where the failure has affected the person’s ability to live a normal life but where we expect this to resolve in the fullness of time.
30. We consider the emotional impact on Mrs K which occurred due to the Trust’s failure to be within level three of our SOI scale. We recognise Mrs K experienced distress and inconvenience during a time when she should have been focussing on her own recovery and bonding with her baby. We also think the emotional impact of the memories linked to this experience will resolve over time. This is in line with level three of our SOI scale.
31. We contacted the Trust about this. The Trust has agreed to pay Mrs K £1,000 in recognition of the distress and inconvenience she has suffered. This is in line with our SOI and similar cases we reviewed. The Trust has agreed to contact Mrs K within four weeks of the date of our decision to make arrangements to pay Mrs K. We understand it may take the Trust two months following receipt of these details to make the payment.
32. We hope this assures Mrs K the Trust has taken her complaint seriously. We think the Trust has now taken steps to remedy the impact she experienced which are in line with Our Principles for Remedy.
33. We are very sorry to hear of the distress Mrs K suffered following her unplanned home birth. We appreciate Mrs K’s view the Trust should compensate her for the items she says she purchased as a result of the Trust’s actions. We have seen Mrs K could have claimed for these items through her home insurance. We consider the resolution offered by the Trust is enough to remedy the emotional impact Mrs K experienced. We thank Mrs K for bringing her complaint to us.