Mother made informed birth choice before baby's death
The woman, who cannot be identified, tried to have the home birth but her son was ultimately born via Caesarean at a regional Victorian hospital in August 2022 after complications arose.
The infant, known as Baby R, died in hospital six days later from perinatal hypoxia.
A week-long inquest into the child's death started on Monday, where coroner Dimitra Dubrow will seek to assess the mother's suitability for a home birth and whether Baby R's death was preventable.
Dr Veronica Moule told the court she assisted the mother with her first pregnancy but the woman only had one appointment with her in February 2022 when she was 12 weeks' pregnant with Baby R.
The woman wanted a vaginal birth after having a Caesarean with her first child so there was a risk she could have a uterine rupture while delivering Baby R, Dr Moule said.
The woman's first child was also macrosomic, or born at a larger than average birth weight, which placed the woman at greater risk during a vaginal birth, the GP said.
Dr Moule told the court she still determined the woman was "potentially suitable" for a home birth and she understood the mother made an informed decision to proceed with her desired birth plan.
The GP believed she advised the woman to see an obstetrician in accordance with health guidelines but the mother said she did not receive that advice.
The court was told Bendigo Health contacted the mother to see an obstetrician at 36 weeks but the woman declined the appointment.
Dr Moule said some of the risks, especially the risk of macrosomia, could have been identified at the later stage of the woman's pregnancy.
The GP said the woman had a "very strong desire" to have a home birth after having a traumatic experience during the birth of her first child.
The woman had already contacted a homebirth midwife when she was four weeks' pregnant and was creating a space in her shed for other women to home birth in, Dr Moule said.
The woman went into labour with Baby R about 5am on August 19, 2022, and her two private midwives arrived at her house shortly after for the home birth, the court was told.
The mother laboured for several hours but the birth was not progressing and she experienced complications so she was taken to Bendigo Health about 8pm.
Testing revealed the baby's heart rate was faster than normal so he was delivered via Caesarean about 9.36pm.
After his birth, he had to be intubated and started experiencing seizures so he was transferred to Melbourne's Royal Women's Hospital via ambulance.
The baby's prognosis was poor so he was taken off life support and died at 11.37pm on August 25.
The midwives who tried to carry out the home birth will be among the eight witnesses to give evidence.
The inquest continues.
Lifeline 13 11 14
beyondblue 1300 22 4636
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Advertiser
a day ago
- The Advertiser
'Doesn't bring her back': death in custody preventable
An Aboriginal woman's newborn baby was ripped from her arms soon after giving birth while in prison. But Heather Calgaret was not given any mental health support after this traumatic event. Over the next two years behind bars, the mother-of-four became obese, developed type 2 diabetes and suffered depression before being denied parole. She died in custody in November 2021 after given an inappropriately prescribed injectable opioid substitution. Countless missed opportunities to prevent the 30-year-old's death in custody were outlined by a coroner on Monday, as her family and supporters filled the courtroom. "Not only was her passing preventable, she should never have passed in the manner that she did," Victorian coroner Sarah Gebert said as she delivered a 300-page finding. The proud Yamatji, Noongar, Wongi and Pitjantjatjara woman had been six months' pregnant when she arrived at Dame Phyllis Frost women's prison in July 2019. The removal of her baby girl just after giving birth, because she had been denied access to the prison's Living with Mum program, was a "pivotal" moment, the coroner found. "Heather had her other children removed ... and her family had been affected by the Stolen Generation," Ms Gebert said. "Each of these factors would be expected to produce a range of both trauma-related symptoms and feelings of despair." Ms Calgaret was not given access to a psychologist while at Dame Phyllis and her mental health declined. About six months before her death, Ms Calgaret pleaded in a letter to be released on parole. She explained the See Change program she was required to complete was not available at Dame Phyllis and asked to do it outside prison. "I have four children that need me. I believe I have suffered enough," Ms Calgaret wrote in the letter. She begged for someone to "please read and answer my letter", but it was never forwarded onto the parole board. The coroner said Ms Calgaret had been eligible to be considered for parole more than a year earlier, about seven months after her sentence for aggravated burglary was imposed. It wasn't until October 2021 - a month before she died - that she was told her parole application had been denied because of a lack of suitable accommodation. On November 22, a doctor gave her a dosage of opiate replacement therapy that was too high for her tolerance level. Ms Calgaret's sister Suzzane, who was housed with her at the prison, found her struggling to breathe the following morning. She shook Ms Calgaret to let her know it was time for the daily count, but her younger sister was not moving. A "code black" was called and she was taken to hospital where she died four days later. The Correct Care Australasia doctor had "lacked the careful consideration required" to prescribe the injectable drug, the coroner said. She found Ms Calgaret would not have died if she had not been given the drug, or if she had been supervised afterwards. Suzzane Calgaret welcomed the findings but said it should not have taken her sister's death for changes to be made. "I hope they just have learned from this because it's taken my sister's life, my mum's daughter's life," she said outside court. "There's a reason now for her passing and that reason has been justified by the outcome, but it doesn't bring her back." Ms Gebert issued 16 recommendations, including monitoring women who give birth in custody for post-natal mental health treatment. She encouraged Justice Health to work with the government and stakeholders to improve the psychological services available at the prison and their care of inmates with chronic health issues. Ms Gebert said the parole application process should be reviewed to ensure it does not undermine the integrity of prison sentencing. 13YARN 13 92 76 Lifeline 13 11 14 An Aboriginal woman's newborn baby was ripped from her arms soon after giving birth while in prison. But Heather Calgaret was not given any mental health support after this traumatic event. Over the next two years behind bars, the mother-of-four became obese, developed type 2 diabetes and suffered depression before being denied parole. She died in custody in November 2021 after given an inappropriately prescribed injectable opioid substitution. Countless missed opportunities to prevent the 30-year-old's death in custody were outlined by a coroner on Monday, as her family and supporters filled the courtroom. "Not only was her passing preventable, she should never have passed in the manner that she did," Victorian coroner Sarah Gebert said as she delivered a 300-page finding. The proud Yamatji, Noongar, Wongi and Pitjantjatjara woman had been six months' pregnant when she arrived at Dame Phyllis Frost women's prison in July 2019. The removal of her baby girl just after giving birth, because she had been denied access to the prison's Living with Mum program, was a "pivotal" moment, the coroner found. "Heather had her other children removed ... and her family had been affected by the Stolen Generation," Ms Gebert said. "Each of these factors would be expected to produce a range of both trauma-related symptoms and feelings of despair." Ms Calgaret was not given access to a psychologist while at Dame Phyllis and her mental health declined. About six months before her death, Ms Calgaret pleaded in a letter to be released on parole. She explained the See Change program she was required to complete was not available at Dame Phyllis and asked to do it outside prison. "I have four children that need me. I believe I have suffered enough," Ms Calgaret wrote in the letter. She begged for someone to "please read and answer my letter", but it was never forwarded onto the parole board. The coroner said Ms Calgaret had been eligible to be considered for parole more than a year earlier, about seven months after her sentence for aggravated burglary was imposed. It wasn't until October 2021 - a month before she died - that she was told her parole application had been denied because of a lack of suitable accommodation. On November 22, a doctor gave her a dosage of opiate replacement therapy that was too high for her tolerance level. Ms Calgaret's sister Suzzane, who was housed with her at the prison, found her struggling to breathe the following morning. She shook Ms Calgaret to let her know it was time for the daily count, but her younger sister was not moving. A "code black" was called and she was taken to hospital where she died four days later. The Correct Care Australasia doctor had "lacked the careful consideration required" to prescribe the injectable drug, the coroner said. She found Ms Calgaret would not have died if she had not been given the drug, or if she had been supervised afterwards. Suzzane Calgaret welcomed the findings but said it should not have taken her sister's death for changes to be made. "I hope they just have learned from this because it's taken my sister's life, my mum's daughter's life," she said outside court. "There's a reason now for her passing and that reason has been justified by the outcome, but it doesn't bring her back." Ms Gebert issued 16 recommendations, including monitoring women who give birth in custody for post-natal mental health treatment. She encouraged Justice Health to work with the government and stakeholders to improve the psychological services available at the prison and their care of inmates with chronic health issues. Ms Gebert said the parole application process should be reviewed to ensure it does not undermine the integrity of prison sentencing. 13YARN 13 92 76 Lifeline 13 11 14 An Aboriginal woman's newborn baby was ripped from her arms soon after giving birth while in prison. But Heather Calgaret was not given any mental health support after this traumatic event. Over the next two years behind bars, the mother-of-four became obese, developed type 2 diabetes and suffered depression before being denied parole. She died in custody in November 2021 after given an inappropriately prescribed injectable opioid substitution. Countless missed opportunities to prevent the 30-year-old's death in custody were outlined by a coroner on Monday, as her family and supporters filled the courtroom. "Not only was her passing preventable, she should never have passed in the manner that she did," Victorian coroner Sarah Gebert said as she delivered a 300-page finding. The proud Yamatji, Noongar, Wongi and Pitjantjatjara woman had been six months' pregnant when she arrived at Dame Phyllis Frost women's prison in July 2019. The removal of her baby girl just after giving birth, because she had been denied access to the prison's Living with Mum program, was a "pivotal" moment, the coroner found. "Heather had her other children removed ... and her family had been affected by the Stolen Generation," Ms Gebert said. "Each of these factors would be expected to produce a range of both trauma-related symptoms and feelings of despair." Ms Calgaret was not given access to a psychologist while at Dame Phyllis and her mental health declined. About six months before her death, Ms Calgaret pleaded in a letter to be released on parole. She explained the See Change program she was required to complete was not available at Dame Phyllis and asked to do it outside prison. "I have four children that need me. I believe I have suffered enough," Ms Calgaret wrote in the letter. She begged for someone to "please read and answer my letter", but it was never forwarded onto the parole board. The coroner said Ms Calgaret had been eligible to be considered for parole more than a year earlier, about seven months after her sentence for aggravated burglary was imposed. It wasn't until October 2021 - a month before she died - that she was told her parole application had been denied because of a lack of suitable accommodation. On November 22, a doctor gave her a dosage of opiate replacement therapy that was too high for her tolerance level. Ms Calgaret's sister Suzzane, who was housed with her at the prison, found her struggling to breathe the following morning. She shook Ms Calgaret to let her know it was time for the daily count, but her younger sister was not moving. A "code black" was called and she was taken to hospital where she died four days later. The Correct Care Australasia doctor had "lacked the careful consideration required" to prescribe the injectable drug, the coroner said. She found Ms Calgaret would not have died if she had not been given the drug, or if she had been supervised afterwards. Suzzane Calgaret welcomed the findings but said it should not have taken her sister's death for changes to be made. "I hope they just have learned from this because it's taken my sister's life, my mum's daughter's life," she said outside court. "There's a reason now for her passing and that reason has been justified by the outcome, but it doesn't bring her back." Ms Gebert issued 16 recommendations, including monitoring women who give birth in custody for post-natal mental health treatment. She encouraged Justice Health to work with the government and stakeholders to improve the psychological services available at the prison and their care of inmates with chronic health issues. Ms Gebert said the parole application process should be reviewed to ensure it does not undermine the integrity of prison sentencing. 13YARN 13 92 76 Lifeline 13 11 14 An Aboriginal woman's newborn baby was ripped from her arms soon after giving birth while in prison. But Heather Calgaret was not given any mental health support after this traumatic event. Over the next two years behind bars, the mother-of-four became obese, developed type 2 diabetes and suffered depression before being denied parole. She died in custody in November 2021 after given an inappropriately prescribed injectable opioid substitution. Countless missed opportunities to prevent the 30-year-old's death in custody were outlined by a coroner on Monday, as her family and supporters filled the courtroom. "Not only was her passing preventable, she should never have passed in the manner that she did," Victorian coroner Sarah Gebert said as she delivered a 300-page finding. The proud Yamatji, Noongar, Wongi and Pitjantjatjara woman had been six months' pregnant when she arrived at Dame Phyllis Frost women's prison in July 2019. The removal of her baby girl just after giving birth, because she had been denied access to the prison's Living with Mum program, was a "pivotal" moment, the coroner found. "Heather had her other children removed ... and her family had been affected by the Stolen Generation," Ms Gebert said. "Each of these factors would be expected to produce a range of both trauma-related symptoms and feelings of despair." Ms Calgaret was not given access to a psychologist while at Dame Phyllis and her mental health declined. About six months before her death, Ms Calgaret pleaded in a letter to be released on parole. She explained the See Change program she was required to complete was not available at Dame Phyllis and asked to do it outside prison. "I have four children that need me. I believe I have suffered enough," Ms Calgaret wrote in the letter. She begged for someone to "please read and answer my letter", but it was never forwarded onto the parole board. The coroner said Ms Calgaret had been eligible to be considered for parole more than a year earlier, about seven months after her sentence for aggravated burglary was imposed. It wasn't until October 2021 - a month before she died - that she was told her parole application had been denied because of a lack of suitable accommodation. On November 22, a doctor gave her a dosage of opiate replacement therapy that was too high for her tolerance level. Ms Calgaret's sister Suzzane, who was housed with her at the prison, found her struggling to breathe the following morning. She shook Ms Calgaret to let her know it was time for the daily count, but her younger sister was not moving. A "code black" was called and she was taken to hospital where she died four days later. The Correct Care Australasia doctor had "lacked the careful consideration required" to prescribe the injectable drug, the coroner said. She found Ms Calgaret would not have died if she had not been given the drug, or if she had been supervised afterwards. Suzzane Calgaret welcomed the findings but said it should not have taken her sister's death for changes to be made. "I hope they just have learned from this because it's taken my sister's life, my mum's daughter's life," she said outside court. "There's a reason now for her passing and that reason has been justified by the outcome, but it doesn't bring her back." Ms Gebert issued 16 recommendations, including monitoring women who give birth in custody for post-natal mental health treatment. She encouraged Justice Health to work with the government and stakeholders to improve the psychological services available at the prison and their care of inmates with chronic health issues. Ms Gebert said the parole application process should be reviewed to ensure it does not undermine the integrity of prison sentencing. 13YARN 13 92 76 Lifeline 13 11 14
ABC News
a day ago
- ABC News
Inquest begins into Baby R's death at Bendigo Health after planned home birth
A coroner's court has heard a mother whose baby died after a home birth in central Victoria, did not want to deliver at a local hospital after facing a traumatic first birth in 2019. Baby R, as the infant is being referred to during the coronial inquest, died from perinatal hypoxia in August 2022 after an emergency caesarean at Bendigo Health. The parents of Baby R, who cannot be identified, read statements to the court in Melbourne today on day one of the inquest. The court heard the baby boy's parents initially assumed they would be unable to have a home birth as their first child was born by emergency caesarean in 2019. However two different doctors referred Baby R's mother to private midwives as part of her options for her second birth. Baby R's mother described a "what if" moment during the home birth, when she noticed meconium liquor as she moved from her bedroom to the lounge room. Meconium liquor is waste usually passed by a baby after birth. In her statement to the court, the mother recalled saying "oh f***", and assumed she would be on her way to hospital. "I remember [the midwife] Mary Louise just saying, 'We'll monitor you more closely'," the mother said in her statement. The baby's mother was herself a registered midwife and had worked as both a nurse and midwife before leaving healthcare following a difficult first birth. The statement from Baby R's father painted the home birth as "calm", before he and the baby's mother made the decision to quickly go to Bendigo Health after complications arose. A midwife called ahead to the hospital to prepare. "When they came to me they said she was having a caesar. I thought 'Oh, here we go again," Baby R's father said. He said after the birth, the baby "wasn't breathing, wasn't squawking". "They took him straight to [paediatrics]," he said. The court also heard Baby R's mother declined an appointment with an obstetrician prior to the birth. She said it felt like an administrative call and questioned why it would be necessary, as no health care providers had flagged the need for an obstetrician consult pre-birth. "It felt like a box ticking exercise," her statement said. Counsel assisting told the court a consultant obstetrician at Bendigo Health assessed Baby R's mother as "high risk" after reviewing her file following the birth. GP Dr Veronica Moule had a 12-week prenatal consultation with Baby R's mother in 2022 and gave evidence on Monday. The court heard Dr Moule was not made aware the mother had a postpartum haemorrhage following her first birth. "I did not receive a discharge summary from Bendigo Health after that; that's where the information would've been written," Dr Moule said. Dr Moule said had she known, she may not have said Baby R's mother was a suitable candidate for a vaginal home birth. "The outcome was tragic," she said. When questioned if it was possible to make an informed decision without a consultation with an obstetrician pre-birth, Dr Moule said "possibly not." Coroner Dimitra Dubrow indicated on Monday morning both midwives involved in Baby R's birth would object to giving evidence in the coronial inquest. The court heard the midwives, Marie-Louise Lapeyre and Elizabeth Murphy, were concerned the evidence may expose them to civil liability. Following investigations by the Australian Health Practitioner Regulation Agency and the Nursing and Midwifery Board, both Ms Murphy and Ms Lapeyre have been told they cannot practise as private midwives, along with other conditions. The inquest will continue tomorrow.
Sydney Morning Herald
a day ago
- Sydney Morning Herald
An Indigenous woman's baby was taken from her. It was a ‘pivotal moment' before she died in prison
Aboriginal and Torres Strait Islander readers are warned that the following article contains images and names of deceased people. An Indigenous woman's newborn had been taken from her, she had been denied parole and then a doctor prescribed her a high dose of synthetic opiates leading to her death. Heather Calgaret's death in custody was preventable and her health in prison had deteriorated from the moment her baby was removed from her at birth, a coroner found on Monday. 'Not only was her passing preventable, she should never have passed in the manner that she did,' Victorian Coroner Sarah Gebert said as she delivered a 300-page finding following an inquest. The 30-year-old Yamatji, Noongar, Wongi and Pitjantjatjara woman had been six months pregnant when she arrived at Dame Phyllis Frost women's prison, in Melbourne's outer west, in July 2019. The removal of her daughter – which Calgaret had described as 'hell' – was a pivotal moment in her overall health decline while in custody, Gebert found. She experienced depression, grief, shame and trauma from the child's removal and separation from her three other children, became obese and was diagnosed with diabetes over her next two years in prison. Calgaret pleaded to be released on parole about six months before her death, writing a letter expressing frustration as one of her parole conditions was to complete a program that was not available. 'I have been told I need to complete the See Change program to complete parole. Dame Phyllis Frost is not running it,' she wrote, as she asked to be permitted to complete the program outside prison.
