Inquest hears mother's concerns over caesarean section before baby's death

An inquest into the death of a newborn at a central Queensland hospital has heard his mother felt she was "dismissed" by doctors when she requested a caesarean.

Alby Spreadborough died at Emerald Hospital on February 6, 2023, after an obstructed labour, a condition that occurs when the baby cannot move through the birth canal.

The second coronial inquest into his death heard from his parents, Tim and Rebecca Spreadborough, and doctors.

Parental concerns

The court heard that while in "excruciating pain" during labour, Ms Spreadborough asked her midwife, "Can they cut it out of me?", but was advised by her doctor to continue the vaginal birth for another hour.

"I was a vulnerable mother in labour in excruciating pain," Ms Spreadborough said.

"I had trust in my care team, so I trusted they were making the right decisions for me."

She said she felt there was "pushback" from her doctor regarding having a caesarean section after her initial request.

"I felt there was lots of pressure and encouragement to continue birthing vaginally," she said.

Assisting counsel Geoffrey Diehm asked Ms Spreadborough if the doctors may have been waiting to ensure she was sure she wanted to proceed with having a caesarean.

Ms Spreadborough said discussions were not balanced and were weighted towards the vaginal birth.

She said she later "firmly requested" a caesarean section and was taken into the operating theatre.

"I was already at a point where I couldn't bear any more pain … I reaffirmed my request for a caesarean section," she said.

Ms Spreadborough told the court that during the caesarean operation she realised something had gone wrong and that doctors were attempting to revive her baby.

"No-one came to me to communicate to me what had happened, but I could hear in the room what was happening," she said.

Both Ms Spreadborough and her husband told the court they did not recall any discussions with doctors about abnormalities in scans.

"The only thing I recall is them saying baby is really happy on the CTG [cardiotocograph]," Ms Spreadborough said.

Rare medical phenomenon

The court heard Emerald Hospital did not have a dedicated paediatrician at the time.

Rural generalist Brooke Davies, who was the doctor during the birth, told the inquest Ms Spreadborough had developed a rare medical phenomenon called a Bandl's ring, which is a ring of muscle that constricts between the upper and lower sections of the uterus.

She said it was the first time she had seen the ring in a patient and that she cut through the ring, but it remained tight.

"[It was] like I had cut through a steel ring rather than a rubber band," Dr Davies said.

She said initial scans of Alby and Ms Spreadborough did not indicate highly concerning abnormalities.

The inquest

The inquest, before Deputy State Coroner Stephanie Gallagher in Townsville, will consider whether a caesarean section should have been performed earlier and if it had, whether Alby would have died.

The inquest will also investigate if the "manner and performance" of this operation contributed to the baby's death.

Evidence about medical procedures and decisions throughout the birth will also be examined.

The four-day inquest continues.