Home birth in spotlight at Perth inquest

An inquest into the deaths of three babies who were born at home has begun in Perth.

The West Australian Coroner's Court heard on Tuesday that an infant, known as Baby C for legal reasons, started grunting and struggling to breathe within the first hour of his life in February 2010.

The home birth had been attended by two registered midwives, although one of them had not met the mother before she went into labour.

They decided to rush the baby to Fremantle Hospital and despite efforts to revive him, he was pronounced dead just over an hour later, with one of the causes of death determined to be Group B streptococcal infection.

The inquest seeks to clarify the circumstances in which he died, given little is known about what information was provided to his parents about home birthing risks, why the mother was not transferred to hospital sooner and what may have led to the baby becoming infected with the bacteria.

In the case of Baby B, the inquest seeks to clarify, among other things, why an obstetrician at King Edward Memorial Hospital (KEMH) who had determined the mother should not have a home birth due to previous foetal complications was not told of her plan to go ahead with it.

He had expressed his concerns to the publicly-funded Community Midwifery Program, but no one got back in touch with him.

Before the mother gave birth, she complained of a headache and ringing in her ears, and was advised by the midwife to go to KEMH, where she was tested.

After being discharged home in May 2010, she gave birth, but the baby was floppy and not breathing, and the midwives could not feel a heartbeat.

They moved to resuscitate him and he was rushed by ambulance to Armadale Hospital.

While he was breathing when he arrived, he was displaying seizure-like behaviour and was diagnosed with hypoxic brain damage.

Because of the extent of the damage, he was sent home and died three days later.

The inquest will seek to clarify the circumstances in which the woman was released home from hospital after complaining about feeling ill.

In the case of Baby P, the mother employed a woman who was not a registered midwife, but who she believed to be fully qualified, to handle her birth of twins at home in July 2011.

The first baby was healthy, whereas Baby P was not breathing and did not have a heartbeat.

The unregistered midwife and a registered midwife who was helping her tried to resuscitate him, but had to call an ambulance, which arrived 18 minutes later.

On arrival at hospital, resuscitation continued and the baby was repeatedly given adrenaline.

Eventually a slow and faint pulse of 70 beats per minute was heard, but dropped to 30.

Notwithstanding these measurements, resuscitation ceased and the baby was considered a still birth.

A neonatologist provided an opinion to the court that it was possible that the baby may have responded to such resuscitation had he been born in a hospital.

The inquest continues.