A woman, who had suffered two previous stillbirths, struggled to fight back tears as she told an inquest how another baby died three days after suffering complications during his birth at Mayo University Hospital in Castlebar in 2018.
Breda Hunt described how she got to hold her son's "tiny little hand" in ICU before he was rushed away for treatment.
A sitting of Dublin District Coroner's Court heard evidence from an expert witness that doctors at MUH should have considered arranging for an earlier delivery of the baby given the patient’s medical history involving deaths of perfectly-formed babies.
Peter McKenna, a former master of the Rotunda Hospital, said Ms Hunt should have been given a commitment during her pregnancy that her baby would be delivered no later than 36 weeks.
Her son Cian was born on 3 October, 2018 at 37 weeks and five days' gestation by Caesarean section following a failed attempt at a natural delivery.
"Persistent attempts to achieve a vaginal delivery were inappropriate," said Dr McKenna.
The obstetrician said there was "a real and well-anticipated risk" that Ms Hunt could experience a recurrence of a placental abruption which had caused the stillbirth of another son, David, in 2012.
Counsel for MUH, Luán Ó Braonáin SC, said there were other medical experts who would disagree with Dr McKenna’s view which meant his evidence represented "a deep unfairness" to the hospital.
Ms Hunt, who was considered a high-risk patient because of her previous history, told the inquest that she never had any discussion with doctors at MUH about the risk of prolonging another pregnancy.
Cian died at the Coombe Hospital on 6 October, 2018 - three days after being airlifted to Dublin to get specialist treatment to reduce swelling on his brain.
The inquest heard evidence that Ms Hunt was in induced labour for 18 hours without any progress before a decision was taken to carry out an elective Caesarean section.
There were further delays in her being brought to theatre because of an emergency case involving another pregnant woman and the fact that only one of the hospital’s two theatres was available.
The coroner, Myra Cullinane, was informed that Ms Hunt had been admitted to hospital over a week before her due date because of her past medical history.
Dr McKenna said baby Cian could have been delivered as early as 32 weeks and noted that early delivery could avoid adverse outcomes in most similar cases.
He said Ms Hunt’s loss of three children to perinatal deaths must be "devastating beyond imagination."
Crying at regular intervals, Ms Hunt, who has two other children, told the inquest that she was "excited but nervous" on discovering that she was pregnant in early 2018.
Ms Hunt (36) of Rathnagussane, Kilmovee, Co Mayo, said she was reassured by regular scans over the following months at MUH and by her consultant Dr Murtada Mohamed who indicated he would section her at approximately 36 weeks.
However, she said that changed 12 weeks before her due date as Dr Mohamed believed it would be better if she had a natural birth like her previous four deliveries.
Ms Hunt said she had been reassured that bleeds she had during the two stillbirths were due to shock and placental abruption respectively.
The inquest heard Ms Hunt was admitted to MUH on 24 September, 2018 and told two days later that she would be induced on 2 October before a decision was ultimately taken around 4am on 3 October to carry out an elective Caesarean section because of a failed induction.
Ms Hunt said she understood everything was fine with her baby's heartbeat at the time and was "all excited" as she was being brought to theatre.
She said Cian’s heartbeat was a little faint when it was checked in theatre. "I did say to the nurse/midwife that he was playing tricks on us but nobody seemed stressed or alarmed," she added.
However, Ms Hunt said a green sheet was suddenly put up in front of her and Cian was "pulled out" at 10.10am and rushed over to a paediatric team.
Ms Hunt said she and her husband, David, were informed that doctors were working on Cian and that he was being brought to a specialist unit.
She was informed by Dr Mohamed that she had suffered a placental abruption during the surgery and had lost 2.8 litres of blood.
Ms Hunt said she was transferred to an intensive care unit "without seeing my son, knowing how he was or where he was."
In a faltering voice she described how she got to meet her son for the first time in the ICU and got to hold "his tiny little hand" before he was rushed away for treatment.
Ms Hunt said doctors and nurses told her how sorry they were and that nobody had anticipated what had happened.
Dr Mohamed was not available to give evidence to the inquest.
However, a senior registrar at MUH, Tarig Awadalla, said his colleague was "in two minds" about how Ms Hunt's baby should be delivered.
Asked by the coroner if the original plan was that Ms Hunt would have an elective Caesarean section at 36 weeks, Dr Awadalla said Dr Mohamed had never made a clear cut decision.
Counsel for the Hunt family, Sara Antoniotti BL, pointed out that doctors at MUH had used different methods at different times to calculate Ms Hunt’s due date.
"Timing is important," said Ms Antoniotti, referring to Ms Hunt already experiencing two previous stillbirths.
Senior midwife, Marcella Gavin, said she had no concerns about the baby’s heartbeat when it was checked just over one hour before he was born as it was "regular and audible".
A post-mortem on baby Cian’s body found he had died as a result of a lack of blood and oxygen to the brain and multi-organ failure due to an acute placental abruption.
Dr Cullinane said a pathologist’s report showed the condition arose at or around the time of Cian’s birth.
The inquest heard several changes have been made at MUH since Cian’s death including the introduction of weekly discussions about high-risk patients, while all decisions on their planned care are documented.
The hearing was adjourned until tomorrow when legal submissions will be heard in the case.
