Family of mother who died in childbirth hope 'lessons can be learned'

Family of 32-year-old mother who died during childbirth after ‘C-section recommendation was lost’ hope that ‘lessons can be learned’ from her tragic death

  • Lucy Howell’s family paid tribute to ‘beloved’ mother after inquest into her death
  • READ MORE: Mother, 32, who died during natural birth after recommendation to have a C-section was ‘lost’ may not have survived even if she had the procedure

The family of a woman who died in childbirth after a recommendation she have a caesarean section was ‘lost’ said that they hope ‘lessons can be learned’ from their tragic loss.

Lucy Howell’s family paid tribute to their ‘beloved’ wife, mother and daughter and said that they hope no other family has to go through the same pain they have experienced and continue to go through.

On the final day of the inquest into her death today, the coroner ruled that Lucy may not have survived even if doctors had known about the C-section recommendation.

Lucy Howell opted for a natural birth for her second child despite a surgeon’s concerns she would be in danger if she did.

Tragically, during the delivery the 32-year-old suffered a uterine rupture resulting in an amniotic fluid embolism and, while her daughter Pippa survived, she passed away.

Lucy Howell’s family said that they hope ‘lessons can be learned’ from her loss, after she died in childbirth

Lucy Howell with her husband Matthew Howell shortly after the birth of their first child

In what has been an ‘extremely painful’ week for her family, they learned that the decision on how to counsel Lucy on what mode of delivery she might choose was made ‘on the basis of a brief discussion at a photocopier,’ their lawyer said.

The inquest in Winchester heard that Lucy had undergone a caesarean for the birth of first daughter Rosie in 2017, which required specialist ‘niche’ surgery to repair. 

Following this procedure the specialist who operated on her advised against any having a natural birth with any future pregnancy, a recommendation that got ‘lost’ amid other ‘inconsistencies’.

Four years later when she was expecting her second child the consultant planning Mrs Howell’s baby delivery method did not ask the specialist about the surgery he had performed.

Coroner Mrs Rosamund Rhodes-Kemp today concluded that even if Lucy had had a C-section there was ‘no evidence’ to prove she wouldn’t have suffered the same fate. 

Addressing the family during the inquest, Mrs Rhodes-Kemp said: ‘I’m very, very sorry for your loss.’ 

Coroner Mrs Rosamund Rhodes-Kemp concluded that even if Lucy had had a C section there was ‘no evidence’ to prove she wouldn’t have suffered the same fate

Commenting on behalf of Lucy’s family, their solicitor, Emma Beeson said following the inquest: ‘This has been an extremely painful week for Lucy’s family. 

‘They have found it very difficult to learn that the decision regarding how to counsel her on the mode of delivery was made on the basis of a brief discussion at a photocopier which was not documented in her notes at the time by either clinicians. 

‘They heard how there were conflicting views on the induction of her labour, various miscommunications and that there is a lack of national guidance on the method of delivery following uterine niche surgery. 

‘They had raised a number of concerns in respect of the management of Lucy’s pregnancy and her labour. 

‘They are grateful that these were taken seriously by the Coroner, and that significant time was allowed for evidence to be considered from a large number of witnesses and experts to explore these concerns. 

‘The family also recognises that the circumstances surrounding Lucy’s death has had a substantial impact on the midwives and clinicians involved. 

‘As the Coroner has expressed this week, the team involved in trying to save Lucy’s life worked extremely hard and the family are very thankful for this. 

‘Sadly, despite the doctor’s best efforts, Lucy could not be saved. 

‘Her absence is felt deeply every day and her family hope that lessons can be learned from their tragic loss so no other family has to go through what they have and are continuing to deal with. 

The coroner said Avideah Nejad, a clinical director at Hampshire NHS Trust, had come across as ‘defensive’ when giving evidence

‘Lucy’s family will understandably need time to process all of the information they have heard over the last week and ask that their privacy during this time is respected.’

The court heard that environmental engineer Lucy, of Bishop’s Waltham, had ‘wrestled’ with baby delivery methods but opted for a natural delivery having been ‘assured’ it was safe.

Following the birth of her first daughter, specialist consultant surgeon Mr Shaheen Khazali had performed ‘niche’ surgery on her in London, after her ‘extremely painful’ and ‘torrid’ time recovering from the caesarean. 

Due to the risks, Mr Khazali had advised her to avoid a natural birth in any subsequent pregnancy. 

However, that advice was ‘lost’ when consultant obstetrician Jean Goodman, who was helping plan her delivery method, did not speak to him personally.

If she had, she said she would not have later recommended for Mrs Howell to have her labour medically induced, it was heard.

Mrs Rhodes-Kemp criticised Ms Goodman for not speaking to Mr Khazali himself, saying: ‘To me that was the obvious thing to do from the get-go.

‘To speak to the gentleman who had performed the procedure: ‘what are the pros and cons? What’s your advice to this lady? And I’d like to know more information’.’

Lucy was also not made aware of medical literature that showed as many as 96 per cent of women who underwent the same procedure had gone on to choose C sections with later pregnancies. 

Lucy Howell had undergone a caesarean for the birth of first daughter Rosie in 2017 (pictured together)

Her husband, Matthew, told the hearing despite having a preference on baby delivery method, she was happy to be ‘guided’ by the professionals and said she only continued with idea of natural birth, because she ‘had been assured’ it was safe.

Mr Howell said his wife worried of being ‘selfish’ for wanting a natural birth in order to prevent another long recovery, and texted him saying: ‘What if it all goes wrong? What if I die?’

Concluding the inquest into her death today, Mrs Rhodes-Kemp said: ‘When specifically asked, it is clear none of the doctors had spoken to Mr Khazali, had access to his notes or come across a niche repair.’

She added: ‘What is most striking is the sheer devastation Lucy’s death has caused all of the family.’

In March 2021 she was admitted to Royal Hampshire County Hospital in Winchester to be induced, and she died in labour.

The hearing in Winchester heard a Avideah Nejad, a clinical director at the NHS trust that treated Mrs Howell, admitted telling staff to alter notes ‘retrospectively’ after her death.

Mrs Rhodes-Kemp told the hearing Avideah Nejad, of Hampshire NHS Trust, had come across as ‘defensive’ when giving evidence. 

The Healthcare Safety Investigation Branch concluded that a senior review should have taken place when risks appeared to be ‘accumulating’ during Mrs Howell’s labour.

It added that the support for Mr Howell after his wife’s death left him ‘very, very much alone in the early days’ following discharge from hospital.

The hearing was told Mr Howell was given the phone number of a charity to contact.

Today, after a four day inquest, a narrative conclusion was recorded by Hampshire Area Coroner.

She said: ‘Lucy Howell died on the 13 March 2021 due to a uterine rupture and amniotic fluid embolism following a trial of labour that was her preference.

‘This was on a background of a C section in 2017 and a laparoscopic niche repair surgery in 2019.

‘None of the obstetricians involved in her care had experience of that procedure.

‘Had they known and conveyed that information to her, she may have chosen to have an elective C section.

‘However, while this may have avoided the rupture, there is no evidence to say she would have avoided the amniotic fluid embolism and therefore her tragic death.’

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