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Senior doc calls for action after baby's death at Waikato Hospital

Medical staff have raised concerns about how elective caesarean sections are managed at Waikato Hospital (file photo).

A senior doctor is calling for urgent changes to how Waikato Hospital manages planned caesarean sections following a baby's death.

In leaked documents, specialist anaesthetist Margot Rumball said mothers and babies' lives were repeatedly put at risk and accused hospital managers of inaction.

Waikato DHB confirmed a baby died at the hospital in December but declined to detail the circumstances of the death.

A hospital spokeswoman would not confirm if the baby had died after a C-section birth.

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The incident triggered a serious event review.

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Rumball didn't respond to media requests for comment but, in an email to Waikato DHB chairman Bob Simcock, said the safety of mothers and babies at Waikato Hospital "should be a no-brainer".

"The community should have confidence that they will be looked after when they attend our delivery suite, but there have been multiple near misses and some adverse outcomes," Rumball wrote.

"Even with a death, they [senior management] have lacked energy or competence to drive a business case through."

Since December 2016, elective C-sections have been carried in the hospital's acute surgical suite.

Previously, planned caesarean sections were carried out in the hospital's acute delivery suite, together with emergency C-sections.

Rumball said scheduling planned C-sections in an acute theatre put women at risk.

A meeting between clinicians and management in September did not give her confidence any changes would happen promptly.

"I will continue to advocate strongly, because it is important, but I don't understand why I feel like I am fighting management to achieve safe practice," she wrote.

"When a major safety issue is identified, Waikato Hospital should be capable of rectifying the systems and processes without instruction from the coroner, the HDC [health and disability commissioner] or the media. Patients should not be used to settle arguments."

In reply, Waikato DHB clinical director of quality and patient safety Dr Doug Stephenson said he was "absolutely certain" mothers and babies were receiving safe treatment at Waikato Hospital.

Changes to planned C-sections had been implemented in December, meaning such procedures were scheduled separately from acute caesarean sections.

Three theatres in the hospital's main theatre block are used for elective C-sections.

Planning is under way to have elective C-sections carried out in one theatre, three days a week, he said.

"From the end of this year, or early next year, we will designate a theatre and that will be for planned caesarean sections and that's an important thing to do," Stephenson said.

Stephenson said he had no knowledge of any "near misses" regarding the safety of mothers and babies.

"The issues raised that separated elective or planned [C-sections] from unplanned happened in December 2016 and that addressed the issues that were beginning to look like it was going to lead to a potential near miss."

Michelle Sutherland, Waikato DHB director of women's and children's health, said the proposed changes meant elective C-sections would be carried out in a dedicated theatre rather than having them move between three theatres.

Last year Dr Narena Dudley, Waikato DHB clinical unit leader of women's health, said moving elective C-sections away from the acute delivery suite was necessary because of the increasing number of complicated pregnancies the hospital was dealing with.

Dudley said it had become evident the hospital had to establish a second theatre to separate planned C-sections from emergency cases.

Stephenson said if Dudley had any concerns about the safety of mothers and their babies she would alert him.

Dudley was not available to be interviewed.

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