The death of a baby boy, delivered by water birth in Cavan General Hospital last year, was caused by "acute near drowning", a pathologist told Dublin City Coroner's Court yesterday.
Baby Harry Eccles died after his mother, Gina (24), gave birth to him at the Cavan hospital on February 26th in a birthing pool with the aid of a midwife.
After birth, he was blue and received emergency treatment at the hospital, before being transferred to the National Maternity Hospital, Holles Street, Dublin.
He began experiencing seizures at 30 hours old and could only breathe with the aid of ventilation. After tests, which showed his prognosis was very poor, and after consultation with his family, he was taken off ventilation at 12.30pm on March 1st, and died 3½ hours later.
Pathologist, Dr Peter Kelehan, found that baby Harry had died of "an acute near drowning event" caused by the inhalation of fresh water.
He said he could find no pre-existing metabolic disease or anything else that could have caused the baby's death.
"The changes [ in the lungs] are consistent with maybe very transient inhalation of fresh water, producing dilution of the blood," he said.
He told coroner Dr Brian Farrell that he was very concerned at the time of the autopsy to find some alternative cause of death, because it would have been better for all concerned if he had, but he could not.
He said the baby's lungs showed "classic" tissue damage associated with fresh water having passed through them and into the circulation, and there were reduced levels of sodium and potassium in the baby's blood samples, which was also consistent with acute near drowning.
However, Dr Alan Finan, consultant paediatrician at Cavan General Hospital, who treated baby Harry three hours after his birth, said he believed the baby had experienced a "neurological insult" before delivery.
He said he came to this conclusion because the baby had made little or no effort to breathe at delivery. If the complication had happened at delivery, he said, it would be normal for the baby to make more of an effort to breathe.
Cavan General Hospital midwife Elizabeth Loughran, who assisted Ms Eccles during the labour and birth, told the court that Ms Eccles was in her second pregnancy, having had a previous miscarriage.
Ms Eccles was keen to give birth in the pool and was considered low risk, she said.
During labour, there were no signs of foetal distress and she was making good progress at the pushing stage, Ms Loughran said. Although she was pushing for a little longer than the "strict 90- minute transfer guidelines", it was not deemed necessary to transfer her to the consultant-led unit.
Ms Loughran said there was approximately 60 to 90 seconds between the "hands-off" birth of the baby's head and the emergence of the rest of its body, at which time she brought it immediately to the surface of the water. The baby was blue and floppy, and she cut and clamped the cord, gave the baby resuscitation and called for help, she said.
However Siobhán Eccles, grandmother to baby Harry, who was at the birth, disputed the midwife's account. She said it was longer than 90 seconds between the birth of the head and the rest of the body and that Ms Loughran had pushed down on her daughter's stomach to aid delivery of the body because Ms Eccles did not experience a second contraction.
The case was adjourned until the end of July to allow counsel for the hospital to seek advice on the pathologist's findings.
