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File photo - Coombe Hospital, Dublin Sasko Lazarov/Photocall Ireland

Inquest hears from woman who claims baby died in childbirth because she was denied a c-section

Chunling Chen told an inquest that her concerns for her babies were dismissed “sarcastically” by doctors and nurses.

A WOMAN HAS claimed she lost one of her twin babies because medical staff at a maternity hospital in Dublin repeatedly refused her request for a Caesarean section after her waters broke.

Chunling Chen told an inquest that her concerns for her babies were dismissed “sarcastically” by doctors and nurses at the Coombe Hospital who stated: “This is not China. The practice in Ireland is that you wait.”

Chunling (36), a Chinese national who lives in Walkinstown, Dublin, told a sitting of Dublin District Coroner’s Court today that her requests for the assistance of an interpreter were also denied.

The inquest also heard claims that she had never been examined by a doctor, despite repeatedly asking to see one.

“I was not given any options in terms of what I wanted in relation to my care,” said Chunling.

However, lawyers for the Coombe Hospital said none of its staff had spoken the words suggested about differences in medical practice between Ireland and China and waiting times for a Caesarean section.

The inquest also heard evidence from nursing staff that there was no real concern about Chunling and her babies after her waters broke as the results of regular monitoring of foetal heartbeats were “normal”.

Baby Yan Ling Yang was stillborn when delivered after 35 weeks on 28 June 2020.  Her twin sister was born safely a short time later.

A consultant obstetrician at the Coombe Hospital, Aisling Martin, said its normal practice for multiple births was to allow a mother to go to 36 weeks before delivery unless there were signs of infection or labour as there were other risks in delivering such babies at an earlier stage.

Prof Martin said the hospital had got an interpreter for Chunling after her baby’s death as it was felt one was needed to help explain “a difficult, devastating event”.

Another consultant obstetrician, Deirdre Murphy, said that if she had been made aware that Chunling wanted an elective Caesarean section on admission on 25 June 2020, she would have advised her one would not have been possible until 29 June 2020 as they were not performed over weekends.

Prof Murphy said she believed there may have been a “misinterpretation” by the patient over emergency and elective Caesarean sections.

However, she accepted it could have arisen from language difficulties.

Prof Murphy agreed that it was “absolutely the case” that the baby would have been born alive if Chunling had been given a Caesarean section when she asked for one.

Chunling told the inquest that she rushed to the Coombe Hospital after her amniotic fluids burst.

She claimed that she was told she would be required to fast as a Caesarean section delivery was planned for the following day.

However, Chunling, who works in a Chinese takeaway, said she was told on the morning of 26 June 2020 that she no longer needed to fast as it would not be performed until the following week.

“I expressed vividly that I wished to give birth as my waters had broken and I know it’s very dangerous not to give birth straight away,” she recalled.

Chunling said her husband had researched the issue on the internet and found that babies in China should be delivered within three days of a woman’s water breaking.

She described feeling quite ill the following day and asking nurses repeatedly if she could be seen by a doctor.

After stressing she wanted to give birth because of concerns for her twin babies, Chunling claimed she was told: “These other women are OK to wait, why aren’t you.”

Chunling recalled how midwives had difficulty in finding a heartbeat in both babies with a CTG monitor.

The inquest heard that an emergency Caesarean section was performed at 4.20am on 28 June 2020 after an ultrasound scan confirmed one of the twins had died in her mother’s womb.

Chunling said she had been very happy to be pregnant with twins on her second pregnancy as it was the first set of twins in her family.

However, the witness said she was “angry” over what had happened in the hospital.

In reply to questions from coroner Cróna Gallagher, Chunling said that the plan of care was for an elective Caesarean section but she believed it would be “done quickly” once her waters broke.

She told her own counsel, Richard Kean SC, that she had not been given any medical reason why she was not given a Caesarean section when she had asked for one.

Cross-examined by counsel for the hospital, Conor Halpin SC, who suggested nobody had spoken the words about differences in medical practice between Ireland and China, Chunling replied: “It is true. I promise they said it.”

Halpin also informed the inquest that records showed the patient was seen on six occasions by a doctor during her stay.

Several doctors and midwives also gave evidence that they did not believe Chunling had any difficulty in understanding English and had no recollection that she had asked for an interpreter.

However, Kean observed that there was a difference between “talking about a spring roll and amniocentesis”.

A post-mortem on the baby’s body showed she had died as a result of a lack of oxygen from a prolapse of the umbilical cord and associated compression of the cord.

Pathologist, John Gillan, said acute compression would have occurred 2-6 hours before death, although there was evidence of some less acute compression for more than seven days.

Dr Gillan said the compression was intermittent rather than continuous which would explain why the problem had not shown up during monitoring of the patient.

Returning a narrative verdict, Dr Gallagher said the case was complex which meant she could not make a finding of death due to natural causes.

Although counsel for Chunling has sought a verdict of medical misadventure, the coroner said it was not clear that there was any specific act or omission which has resulted in the baby’s death.

While she could not resolve the conflict in evidence over the use of an interpreter, Dr Gallagher recommended that the HSE and the Coombe Hospital should consider making more widespread and proactive use of interpreters given the diverse nature of the Irish population.

The coroner said interpreters should particularly be considered in the case of emergency admissions and where partners were not allowed in the hospital which had occurred in the case in question as it happened during Covid-19 restrictions.

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Seán McCárthaigh