A Review of All Cases Involving a Midwife Brought Before the Health and Disability Commissioner 1996 - 2005

Abstract

The findings from two recent high profile Coroner's inquests involving the deaths of two babies under the care of midwives resulted in media frenzy and a call for a review of maternity services by the Coroner. He concluded that midwifery education was inadequate and that there should be more of a medical presence in maternity services. This appears to be a harsh criticism of midwifery and this report details the findings of a more thorough examination of complaints against midwives in order to provide more clarity on this issue. This report investigates the publicly available complaints and opinions published by the Health and Disability Commissioner (HDC) from 1996 to 2005 to compare the rate of complaints involving midwives against other health professionals; the type of breach of the consumer's Code of Rights that occurs; the number of complaints upheld and the consequences of the HDC findings. The HDC is the organisation responsible for investigating complaints against health professionals. This investigation demonstrates how information from the HDC could be used to support the integrity of the midwifery profession. All of the case reports involving a midwife published on the HDC website from 1996 when the reports first became available, to 2005 the most recent reports were downloaded. A content analysis (both qualitative and quantitative) of every case was undertaken and then the data was analysed using simple descriptive statistics. The key findings of the investigations demonstrate that over this ten-year period, midwives featured in less than 10% of all cases. It is clear that there are some strong trends regarding which of the ten consumers' rights, that make up the HDC code, were most frequently breached. There was also valuable information available about when (in the course of the childbearing year), and how those breaches occurred. Making this information available refutes any suggestion that midwifery is any less professionally accountable than other health professionals. It enhances the public image of midwives as credible, independent health professionals, giving confidence to women and midwives alike. It has the potential to generate useful discussion within the profession stimulating research, influencing policy, practice and educational curricula for the future.