Mum who died giving birth was ‘very keen’ to have baby at home, midwife says

A mother who died after giving birth to her daughter at home should have been informed of the risks, her grieving husband told an inquest.

Jennifer Cahill, 34, and her newborn daughter Agnes both died after the birth despite having ‘one of the most intense birth plans’ her midwife had ever seen.

The mother, described as the ‘queen of acts of kindness’, wanted to go into labour at home after a ‘traumatic’ hospital birth for her first son,an inquest at Rochdale Coroner’s Court heard.

But her heartbroken husband said they were not informed of the ‘red flags’ by NHS staff, which could have made her reconsider the decision.

Community nurse Andrea Walmsley told the inquest she was called to the family home in Prestwich on June 2, last year.

She first noticed the ‘very dim’ lighting at the home but didn’t comment as she and her colleague, Julie Turner, had ‘just entered someone’s home’.

Walmsley went on to describe her reaction when she found Mrs Cahill’s birth plan, which indicated she was ‘very keen’ for a home birth.

‘This is the most intense birth file that I have ever read,’ said Andrea. ‘I never said anything to [my colleague] Julie, I just looked at her when I read it.’

Mrs Cahill sadly passed away in hospital four days after giving birth to her daughter Agnes, who would die just hours later.

Prior to giving birth, Walmsley said she was very concerned to see that Jennifer had refused specific medication and observations, including a syntometrine injection, which would have helped prevent excessive bleeding.

She told Coroner Joanne Kearsley that throughout the evening and early hours of the morning, she tried multiple times to obtain Mrs Cahill’s urine sample to no avail, and described Jennifer as ‘very quiet’ mainly speaking to her husband who ‘supported her very well’.

Walmsley said: ‘When I asked for a urine sample, it was almost like she didn’t like what I was saying.’

Rob Cahill, Jennifer’s husband, told the inquest how he had to dial 999 at around 6.45am on June 3 as Agnes was born unresponsive and had not been revived by a nurse’s resuscitation attempts.

He went to the hospital with Agnes. But was told later that his wife was also being rushed to hospital after suffering complications giving birth.

Following their deaths, the choice to have a home birth has been described as ‘out of guidance’ and ‘against advice’ by hospital trust staff, because of concerns stemming from the birth of Jen’s first child.

But Mr Cahill told the court he believes the ‘out of guidance’ and ‘against advice’ phrases were never raised directly with the couple throughout the pregnancy.

‘I never heard that terminology until after the event,’ the risk analyst said.

The cause of Jennifer’s death has not yet been heard during the inquest at Rochdale Coroner’s Court.

Andrea Walmsley told the court she was not aware of Mrs Cahill’s ‘extremely stressful’ first birth, which took place in hospital, and may have been the reason why she was adamant about a home birth.

She had suffered a postpartum hemorrhage, losing more than 800ml of blood – as a result of an episiotomy and tear, and her son Rudy being a large baby.

Mr Cahill previously explained that the ‘traumatic’ birth left his wife struggling with the prospect of delivering a baby in hospital, which she found very stressful. She also felt that she did not have enough midwife support during her first hospital delivery.

When asked why she wasn’t firm with her requests during the care of Mrs Cahill, midwife Walmsley said: ‘We’re well aware of the complaints that have been going around about us, and I think that’s why it is the way it is.’

Also appearing at the court was Dr Azal El-Adwan, a trainee obstetric to whom Jennifer had been referred by a midwife because of her high risk status.

The pair spoke during a meeting on March 5, 2024, during which Dr El-Adwan was tasked with explaining the risks of having a home birth. Here, she told the court, he advised her against it.

Dr El-Adwan said Jennifer was ‘keen to have a home birth’ and she explained to Mrs Cahill about the medication available to her and any plans put in place should she need to be transferred to the hospital.

The court also heard that Dr El-Adwan did not speak to Jennifer about the risks of death, despite her being a high-risk patient.

The doctor said that it was not ‘standard practice’ to speak with mothers about death rates as the risks were very low, adding that she believes Jennifer understood the risks involved.

That meeting concluded with Jennifer stating that while she still had a preference for a home birth, but she would make a final decision once she had had a test to see if she was carrying Group B Streptococcus (GBS), a common bacterium that can pass from a mother to her baby during labour.

Dr Adwan says that she advised Jennifer to take an antibiotic to prevent it anyway, a medication that was only available to mother’s giving birth in hospital.

When asked if she would have referred Jen’s case to another consultant, Dr El-Adwan said: ‘I didn’t feel that it was necessary at the time, but now I think it would have been better to include somebody else.’

The inquest continues.