NURSING SUPERVISORY

Nursing Supervisory

Nursing Supervisory

In recent years there has been an increase in legal claims relating to birth trauma cases. Compensation for such claims, where, for example, a child suffers cerebral palsy as result of hypoxia because of a delayed delivery, can be as much as £3 million to £5 million. The cost of these claims is high due to the level of care that is required. A midwife can be accountable in many of the areas we have looked at. In addition, there are further rules that apply specifically to midwives. (Baer 2004 Pp. 13-16)

These rules have been set down together with a code of practice by the NMC. All midwives should be familiar with these rules and the code of practice. The law relating to midwives makes it clear that it is an offence for a person, other than a midwife or doctor, to attend a woman in childbirth, except in an emergency or in supported recognised training. A person who contravenes this is committing a criminal offence. Common problems encountered by midwives include, for instance, issues of consent, such as when the patient does not want a midwife present at the birth. Or when the patient does not wish to have pain relief and then during labour changes their mind. In this case does the patient have capacity to change their mind? If the patient refuses a caesarean section and such refusal is likely to result in the death of the unborn child, would the midwife have an obligation to save the unborn child regardless of the patient's consent? The law relating to consent has the effect that you cannot compel the patient to undergo treatment if they are a competent adult. Consent is a complicated area and all midwives should be familiar with it. Susan wishes to have a natural birth. She has made it clear to the community midwife she does not want to have a baby in hospital and would like her husband to deliver the baby. She refuses all antenatal care. What should the midwife do? Some patients are keen not to receive antenatal care during pregnancy and wish to have a home birth without the assistance of a midwife.

The patient can refuse treatment provided they are a competent adult. There is no action that can be taken to prevent this even if it is not clinically desirable. You cannot compel the patient to come into hospital. However, it is an offence for someone other than a midwife or doctor to attend a woman in childbirth. Therefore if Susan's husband assists the delivery of the baby then he will be committing a criminal offence, unless he was acting in an emergency. If a midwife is aware of a situation such as this, she should inform the mother and the husband of the law. A midwife should make a good record of the warning given in the notes. (Nursing and Midwifery Council. 2004)

The midwife should also inform their ...