Women’s Hospital urges mums to seek support amid double home birth death

Health officials have encouraged mums-to-be considering a home birth to ensure they have full and frank conversations over their options amid a tragic case in which a mother and baby died following an “out of guidance” procedure. Jennifer Cahill, aged 34, died in hospital on June 3, 2024, after giving birth at her family home in Prestwich, which she shared with her husband, Robert Cahill, and their first child.

Their second child, baby Agnes, also died in hospital four days later. Both mother and child were rushed to hospital separately due to a series of complications.

Mrs Cahill followed ‘an out of guidance procedure’ having believed she was at low risk of any problems after being told her blood loss in a previous birth was minimal. ‘Outside of guidance’ is a term used by some Trusts and NHS bodies to describe situations when pregnant women make decisions that are different from those recommended in, or envisaged by, local or national maternity care guidelines.

Liverpool Women’s Hospital is the largest single-site maternity hospital in the UK, which prides itself on being the hospital of choice for thousands of expectant mothers.

Jane Wilson is a consultant midwife at the hospital on the edge of the city centre. She explained to the LDRS how mums can access masses of support regardless of whether they choose to give birth in a clinical setting or seek to do so at home.

She said: “Part of my responsibility is to run what we call the birth choices service. That is an open service to any of our mums, it’s an additional antenatal appointment, dotted throughout their pregnancy and the idea is that during these appointments we use this as an opportunity to understand what’s important to them, because that’s important to us as well. What their current knowledge base is and does that feel accurate and realistic? Because often there’s information out there in the public domain that sometimes isn’t quite accurate or is conflicting which then makes it very confusing for mums.

“We use these birth choices appointments to understand, to make them feel supported, to make them feel listened to and to understand what is their main motive for wanting a home birth. If it’s relatively low risk with regards to that baby then of course we would support in quite a straightforward manner.”

Jane said where additional risk appears, as was sadly the case with Mrs Cahill in Manchester last year, it’s important mums are able to get a “clear perspective” on the risks of birthing at home. She added: “We would always want to show them round our midwife-led unit and delivery suite and it’s our responsibility to make it clear that their care would be outside of guidance care and while we’ve got a duty of care to support that choice, we definitely don’t want them to be making those decisions without good oversight.

“Sometimes when they come into the midwife-led unit and have a look around, they understand we can have a birth plan that feels supportive. Then sometimes they will change their mind and come in, so from our point of view it’s sharing best practice with them, sharing our experience with them.”

Jane explained how even if mums want to go through a home birth, it is vital to take in all the support available to make the best decision possible.

“My ask for them is not that they should disregard any of that information that they have gathered independently but they include my information alongside the information that they find themselves so ultimately they can make an informed decision that is ultimately right for them.

“If that is outside the guidance, then we will support that but it is tricky because it puts not only the family in more of a potentially vulnerable position, it also puts the midwives emotionally in a vulnerable position as well so it’s very difficult.

“This is real life and even for pregnancies that are hitting milestones and the baby appears to be growing at a sensible rate, all of those hallmarks that we would look for in routine antenatal care, we can sometimes find that we then see complications in labour but we would always have conversations with those mums to say that when we are looking after them in labour they’ll get one to one care, we risk assess the whole way in labour as well that’s mum and baby, and if we’re confident that we can get a birth safely, then of course we would stay at home or we stay on the birthing plan and the midwife unit.

“If we’re not confident that we can achieve that then we’re going to recommend a transfer to the main delivery suite because even though midwives are very experienced, we are trained. That’s when the collaboration between the midwives and doctors becomes so important because they will put the care plan in place and we’ll deliver it.”

The consultant midwife said mums should not be afraid when it comes to asking for help or further information on making the right choice on where to deliver their baby when the time comes. She said: “The main key message for me is for the women to not be afraid and have that conversation with us, when they come to the clinic it absolutely will be balanced counselling.

“Ultimately we want them to feel supported, we want them to be listened to but it’s absolutely essential that they make informed choices and they have to be clear on the boundaries and the risks if they’re considering outside of guidance care. I would just encourage them to always just come and talk to us.”