A series of failures by an inexperienced midwife and hospital staff contributed to the death of a baby boy soon after he was born, a coroner has found.
Adam Barlow was delivered by an emergency caesarean section at Waikato Hospital in October 2009.
He was floppy and unresponsive, but a faint heartbeat was heard and aggressive attempts were made to resuscitate him.
However, he did not survive and his mother, Linda Barlow, was left fighting for her life.
In his findings, released on Wednesday, Coroner Gordon Matenga found the actions of Ms Barlow's midwife, Jennifer Rowan, contributed to Adam's death.
Ms Rowan, who had only been practising as a midwife for nine months at the time of Adam's death, failed to recognise that Ms Barlow's labour wasn't normal, Mr Matenga said.
Ms Rowan ignored a request by Ms Barlow to remain at the birthing facility, instead sending her home for her labour to progress.
Though Ms Barlow returned to the birthing facility and was eventually admitted to Waikato Hospital, Mr Matenga said Ms Rowan failed to keep adequate clinical notes and didn't record her observations of Ms Barlow.
Ms Rowan didn't make hospital staff aware that Ms Barlow's situation was precarious.
Neither Ms Rowan nor hospital staff recognised that urgency was needed when Ms Barlow was admitted, which resulted in a delay in getting her into theatre for a caesarean section.
Further, Mr Matenga found both Ms Rowan and hospital staff failed to review and properly interpret Adam's heartbeat and Ms Barlow's contractions.
These failures prolonged the second stage of labour and meant the womb was deprived of oxygen and Adam died as a result of a lack of oxygen to the brain during birth, Mr Matenga said.Mr Matenga had made a preliminary finding in February 2010 that Adam was not stillborn.
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