A distressed mother left a court in tears after a doctor admitted she should have been brought to hospital days before her baby was stillborn.
Michelle Rocks broke down as an obstetrics specialist told Belfast Coroner's Court mistakes had been made in the management of her care.
Dr Rachel O’Flaherty also accepted the infant’s death could have been avoided if a planned caesarean section had taken place.
She said: “Looking at the facts of the case now, yes, that could have been the case.”
Baby Cara Rocks was stillborn at the Causeway Hospital in Coleraine, Co Derry on June 26th, 2013.
The Northern Health and Social Care Trust, which runs the hospital, has already apologised for her death and accepted a series of failings.
Sorry to family
In a statement prepared for the inquest last year, Dr O’Flaherty, also said sorry to the family.
“I would like to apologise for the distress she has experienced and continues to experience,” she said.
The court heard how Dr O’Flaherty, then a middle grade medic, had seen Ms Rocks on a number of occasions late into her pregnancy.
Crucially, when Ms Rocks presented at 38 weeks’ gestation with baby Cara lying in the wrong position, Dr O’Flaherty advised she be sent home from hospital - a decision the doctor admitted in court was wrong.
When pressed on the issue by barrister Fiona Doherty QC, representing the Rocks family, she said: "In retrospect, I should have kept her in for observation.
“Although she was not in labour and not showing any signs of labour, I probably should have kept her in and got a consultant’s opinion.”
Ms Rocks was days overdue when she was admitted for induction of labour on June 25th, 2013. Baby Cara was stillborn the following day at 4.33pm.
At the time, Dr O’Flaherty was qualified to see medium- to high-risk patients.
Despite her history of a previous C-section, which meant Ms Rocks was high risk, she never saw a consultant for the duration of her pregnancy, it emerged.
It was a matter of “chance” whether or not she saw the consultant, the court heard.
Meanwhile, details of an earlier appointment with Dr O’Flaherty were also given.
While she could not recall the specifics of the meeting on May 20th, 2013, when Ms Rocks was at 36 weeks of pregnancy, Dr O’Flaherty accepted that it appeared a decision not to facilitate the request for an elective C-section was taken.
The Rocks’ family barrister said: “She [Ms Rocks] specifically asked you for a planned C-section and she gave reasons of the experience of her two previous pregnancies.
“She was very clear. She had been through the various options in her previous pregnancies and she knew which one suited her best.
‘In tears’
“She says you told her she was more than capable of delivering herself.
“In fact she was in tears at that appointment. She was incredibly upset.”
However, the doctor had no memory of the consultation other than those documented in the medical notes.
“I can’t remember,” she replied.
According to official guidelines, a final decision on the mode of delivery should be made by 37 weeks.
Following that 36-week appointment, Ms Rocks wrongly believed the decision on the mode of delivery had been taken out of her hands by a senior doctor, the court heard.
Ms Doherty added: “I say there can be no doubt about her request. The notes of that consultation reflect the fact that a decision was made and it was made for a v-bac (vaginal birth after C-section).
Thought decision was made
“After May 20th, she thought she had seen a consultant; she thought the decision was made and she accepted it.
“She did not press it after that.”
The five-day inquest is the first in Northern Ireland to focus solely on the examination of a stillbirth.
Coroner Joe McCrisken has described the case as “historic” and said the region now had legal powers which were the envy of other jurisdictions.
Throughout the hearing, Ms Rocks and her husband Barry have been supported in court by their parents and other relatives.
The inquest continues on Friday.
Press Association