A Dublin woman has questioned how her perfectly formed baby, born after a normal pregnancy at the Rotunda maternity hospital in Dublin four years ago, died within a half an hour of her birth.
Gemma McEvoy wept at an inquest on Monday as she recalled events surrounding the birth of her first child, Molly, who died on July 14th, 2018 after what she described as “the best pregnancy”.
An inquest at Dublin District Coroner’s Court heard medical staff at the Rotunda had attempted to resuscitate the baby girl once problems were noticed with her breathing almost immediately after her delivery, but ceased efforts after 25 minutes.
Ms McEvoy (32) of Casement Road, Finglas, who subsequently gave birth to a baby girl and triplets, said everything was straightforward with Molly’s delivery by Caesarean section.
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“She looked fine and had a little wiggle,” she recalled. “To me I had made it over the finish line.”
Fighting back tears, she added: “It does not make sense that a baby is born in perfect condition and then dies.”
Ms McEvoy, who brought a photo of Molly and her teddy bear to the witness box, said she thought it was her fault that her baby had died before she found out months later that Molly had pneumonia and could not be revived.
She complained that she was never informed by doctors at the Rotunda how her baby had contracted the infection.
Ms McEvoy also claimed she should have been treated with antibiotics after she had informed a midwife at the Rotunda that her waters had broken around 29 hours before Molly was born.
She outlined how she was not believed by a midwife that her waters had broken when she attended the hospital on the morning of July 13th, 2018 – the day before Molly’s birth when she was nine days overdue – after she had noticed a cream-coloured discharge which was “odd and concerning”.
She recalled being told by the midwife, who was “really flippant”, that the discharge meant nothing and her waters were not leaking.
However, Ms McEvoy said she was told to go for a walk and come back in an hour after a test to check if her membranes had ruptured showed “a faint positive”.
She was told that two midwives believed her waters were leaking while another two midwives were uncertain.
Ms McEvoy said a second test after she returned to the hospital was negative which she claimed led the same midwife to remark: “See, I told you your waters weren’t leaking.”
She told the coroner, Cróna Gallagher, that she told herself that “they know best” and returned home feeling “confused and frustrated” as well angry at being “fobbed off”.
“I knew it felt wrong to be sent home,” she said.
The inquest heard she was told to take paracetamol and stay at home as long as possible before her planned induction three days later when she contacted the Rotunda at 7pm that evening with “bad shooting pains” in her stomach.
However, Ms McEvoy decided to return to the hospital shortly after 10.30pm when she believed her contractions had started.
Ms McEvoy said she continued to vomit continuously until after her baby was born around lunchtime the following day when a midwife popped out from behind a sheet “holding our precious baby girl”.
“She looked bigger and more beautiful than we ever imagined,” she added.
Ms McEvoy said she had no concern in the immediate seconds after Molly was born, but she and her husband, Joe had been advised that the baby might not cry immediately and not to be frightened.
However, she said they were then told that doctors were “working on her”, although she was “still not imagining in a million years that she wouldn’t be alive”.
“The thought never crossed my mind. I had the healthiest pregnancy - what could possibly go wrong,” said Ms McEvoy.
After what seemed like forever, she said a doctor informed the couple that “she didn’t make it.”
“The rest of that day was a blur and our lives changed forever,” she remarked.
A pathologist who carried out a postmortem on the baby, Anna Doyle, said Molly had died from congenital pneumonia after inhaling infected amniotic fluid from her mother’s uterus.
Dr Doyle said the most likely cause of the infection “on the balance of probabilities” was when Ms McEvoy’s membranes were ruptured.
The pathologist said she could not say precisely when the infection began but it was likely to be “at least hours into days”.
She agreed with counsel for the McEvoy family, Roger Murray SC, that the risk of infection was greater the longer Ms McEvoy’s ruptured membranes were not treated with antibiotics.
Dr Doyle also agreed with counsel for the Rotunda, Conor Halpin SC, that she was not surprised that it was difficult to resuscitate baby Molly given the extensive congestion of her lungs.
The inquest heard extensive evidence from several doctors at the Rotunda over their efforts to revive the baby girl amid claims by Mr Murray that several hospital guidelines in relation to neonatal resuscitation were not followed.
A neonatologist registrar, Dr Néidín Bussmann agreed with Mr Murray that a baby collapse emergency bleep should be activated after 30 seconds under the guidelines, if a newborn baby’s pulse was under 100 beats per minute or if the infant was not breathing.
The inquest heard evidence that indicated the alert was only activated between two and three minutes after Molly was born.
Consultant neonatologist, Dr David Corcoran, said Molly’s death was a devastating loss for Ms McEvoy and her family in what was “a really unusual situation” after her condition deteriorated rapidly after her delivery.
Dr Corcoran said the hospital’s staff were very experienced and had “an extremely high” successful resuscitation rate for babies with a difficult birth.
The consultant said medical staff had taken all steps possible to resuscitate Molly including intubating and ventilating her as well as administering drugs.
Dr Corcoran said it was not known to doctors at the time that the baby had a major infection with her lungs.
He told the inquest that what occurred was “extremely rare” and he could not recall a similar death in a full-term baby in his professional experience.
The inquest was adjourned and resumes on Tuesday morning.