Grace* was just over 40 weeks pregnant when she arrived at a public hospital in regional New South Wales. The Gamilaraay woman had been excited for the pending birth of her first child, a son called Koa.
Her husband’s job meant he was often away for long stretches of time, but on this day, by chance, he was by her side attending her ultrasound for the first time.
They were both waiting for the reassuring sounds of a heartbeat, a kick to the ribs to let her know her baby was OK. It didn’t come.
“This was his first time seeing our baby on the ultrasound, but it was not a good one. That’s when they told us that it was no heartbeat,” Grace says.
“He was gone.”
It was Grace’s ninth trip to the hospital after a flurry of presentations between her GP, local hospital and a larger major hospital where she had sought help with worrying symptoms. Her hands and feet became puffy at 39 weeks gestation; she was unable to wear her jewellery or watch. She’d had pains in her abdomen from undiagnosed gallstones earlier in her pregnancy but they were dismissed as indigestion.
She visited her GP several times before being advised to go to the small local hospital. Each time her blood pressure was checked, she had given a urine sample and had been advised to go home.
At 39 weeks gestation, she was advised against having her baby induced. One week later, her baby was confirmed to have died of complications from preeclampsia.
After the ultrasound which revealed her son had died, Grace was given medication to bring on labour, told to go and get some dinner and come back to the hospital once contractions had started.
“We went back to the hospital and they gave us a room in the birthing suite away from the other mothers,” she says.
She was in labour for two days.
Grace strongly believes that if she had been listened to when she first began to seek medical attention, her son would be alive today.
‘I refused to believe’
The day Grace speaks to Guardian Australia would have been Koa’s ninth birthday.
Instead, their only interaction was in a CuddleCot, a specialised cot with a cooling system to allow grieving families to spend time with their deceased baby.
“It’s just really hard not to hear like that first cry, and your body just does strange things,” she says.
“He was laying in the little cot, I was looking at him, and just even though I knew, there was still some hope in me that his chest would move, or he’d start crying. I refused to believe what I was going through.”
At those previous medical appointments, Grace says, her blood pressure readings were fluctuating “dramatically”, with some readings very high. She says she consistently showed elevated protein levels in her urine. Both are potential red flags for preeclampsia, a pregnancy complication which can be life-threatening for mother and baby.
After three visits, between her GP and her local hospital, Grace was told by her obstetrician to present to another hospital two hours away, where she was monitored overnight before being discharged and told to go to her local GP. Her blood pressure at the GP clinic read 157/95, indicative of hypertension or preeclampsia.
She was then told to go back to the local hospital to get her blood pressure rechecked – which yielded the same result.
After half an hour her blood pressure dropped and she was told to go home and see her GP again the next day, and have her blood pressure checked every 48 hours.
She says she was advised about decreased foetal movements, and told that her GP was against an induction and advised her to “wait for the baby to be ready to come” – despite her pregnancy complications.
She says a week after she was discharged – after eight visits to her GP and hospital with erratic and high blood pressure readings – she realised she hadn’t felt the baby move, and so ate something to see if that would encourage movement. She said to her husband that she felt they weren’t being listened to. “I don’t actually know what to do at this point,” she said. “We go to the doctor, and they tell us to go to hospital. We go to the hospital, then they tell us to go back to the doctor, and it’s just like a vicious cycle.”
Grace called the maternity ward that had admitted her and was initially told to go to the local hospital before being advised to present to the maternity ward. She says she felt excited that she might get some help. Instead she was told her child was dead.
“There was no real time to process the news,” she says.
“I had to give natural birth and that [took] two days. They would not give me a C-section because they said that I would have mental problems from having to look at a scar on my stomach. But I still have problems from that experience. They treated me giving birth [to a dead baby] like a normal person who’s having a live baby.”
‘Missed opportunities’ in care
Guardian Australia has been investigating Aboriginal and Torres Strait Islander women’s experiences in maternal care and midwifery, uncovering complaints of culturally unsafe care, allegations of discrimination, unwanted medical interventions and infant removals.
Grace says she is unable to say if her Aboriginal heritage was a factor but strongly believes her concern that something was wrong was dismissed by both local doctors and the hospital. She sued NSW Health over the incident and the department settled without prejudice and with no admissions of liability.
Her lawyer, Linda Crawford, a former midwife who now works for Catherine Henry Lawyers, claims Grace was let down by the medical system.
“There were many missed opportunities in the care provided to [her],” Crawford says.
Crawford says she believes there is often a lack of appropriate expertise and medical experience in remote and regional areas that, coupled with the complex needs of patients and the vast areas that small local hospitals cover, can have adverse outcomes despite the best efforts of health professionals.
In response to questions from Guardian Australia, NSW Health says it is “committed to ensuring pregnant women, their babies and families receive high quality, safe and timely maternity care” but would not provide any further comment on Grace’s case.
“We acknowledge the deep and lasting grief associated with the loss of a child and we extend our sincere condolences to all families impacted by stillbirth,” a NSW Health spokesperson said.
Grace, who has since had two more children, says it is vital that women are listened to by health professionals and failure to do so can lead to devastating outcomes.
“All women need to be listened to,” she says. “I just want the right treatment. I wanted to be heard and I wasn’t.”
*Names have been changed
In Australia, the crisis support service Lifeline is 13 11 14. The Indigenous crisis hotline is 13 YARN, 13 92 76. Stillbirth support can be accessed via the Stillbirth Foundation Australia.
