The mother of a newborn baby delivered stillborn at the Midland Regional Hospital in Portlaoise over four years ago has said she believes he would be alive had she been induced earlier.
Baby Timmy McCarthy was delivered stillborn on 16 August 2020.
Visibly upset, his mother Eimear McCarthy, who had previously given birth to five healthy babies, told the infant's inquest that this was a very difficult pregnancy, that she was "constantly in pain", had no appetite and was sick frequently.
She said she had raised with doctors and midwives on a number of occasions throughout her pregnancy that although she was not eating, she was putting on significant weight and that she was worried about the baby.
During her pregnancy she told the inquest that she was diagnosed with gallstones.
She also had gestational diabetes and polyhydramnios, which occurs when there is an abnormally large volume of amniotic fluid surrounding the baby during pregnancy.
Ms McCarthy said towards the end of the pregnancy she voiced concern about reduced fetal movement.
The inquest heard induction of labour two weeks before Ms McCarthy's due date had been scheduled for 6 August.
However, at an antenatal appointment on 4 August a doctor told her the head was too high, and she was not ready for labour.
In her evidence Dr Miriam Doyle, consultant obstetrician gynaecologist at the Midland Regional Hospital in Portlaoise, told the inquest that the antenatal appointment was a "reassuring clinical visit".
She said the pregnancy was progressing as normal and there was no need to push for an earlier induction at that time.
Ms McCarthy said she was given the next available date of 14 August for induction.
However, the inquest heard that when Ms McCarthy was scanned twice on that date, medical staff failed to detect a heartbeat, and she was told her baby had died.
Solicitor for the family Damien Tansey said what is haunting the family is that there is compelling evidence that baby Timmy McCarthy was alive and well on 11 August.
"Had there been intervention, we wouldn't be here," Mr Tansey told the inquest.
Dr Doyle said the issue around the umbilical cord was not known to them at the time and said it is not impossible but very difficult to pick up prior to birth.
She said that on 4 August the pregnancy was progressing and there was no real reason for an earlier induction and added that if there was an emergency then an earlier slot would have been available.
She conceded that had baby Timmy been delivered before 12 August, then "it is probable" he would have lived.
Ms McCarthy told the inquest that she was never offered the option a caesarean section and when cross-examined Dr Doyle said she did not disagree with Ms McCarthy, adding that she could not remember if such a conversation had taken place.
Post-mortem examination
A post-mortem examination carried out by Dr John Gillan found the cause of the death to be hypoxia or a lack of oxygen to the baby, as a result of a true knot of the umbilical cord.
During his examination, Dr Gillan noted excessive amniotic fluid, or polyhydramnios, which occurs when there is abnormally large volume of amniotic fluid surrounding the baby during pregnancy.
Dr Gillan said it is his belief, on the balance of probability, that had the baby been delivered two days earlier the infant would be alive.
Solicitor for the family Damien Tansey told the inquest that Ms McCarthy was high risk by any measure.
However, Counsel for the hospital Caoimhe Daly BL said it was a high-risk pregnancy that was being managed.
She also said the true knot in the umbilical cord was unexpected and could not have been anticipated by staff at the hospital.
Verdict
Coroner Eugene O'Connor expressed his sympathies with Ms McCarthy and her family and acknowledged how difficult the inquest process is.
Returning a narrative verdict of how Timmy McCarthy died after a true knot of the umbilical cord resulting in hypoxia, Mr O'Connor said he hoped the inquest answered some questions for the family.
Afterwards Mr Tansey said it was troubling that an independent inquiry into Timmy McCarthy's death was carried out without the family's knowledge.
Ms McCarthy said it had taken too long for the inquest to be held and it was her belief had she been induced when first planned then her baby Timmy would be alive.
