Charlotte Observer
12:45 am
Thu September 12, 2013

SC Releases Details On Baby's Death At Birth Center

Two midwives’ failure to contact a physician during a complicated labor that resulted in a baby’s death led South Carolina to suspend their licenses as well as the license for a Fort Mill birth center, according to documents released Wednesday.

Pamala Wilson and Jacqueline Kuschner were midwives at Carolina Community Maternity Center in Fort Mill on the night that a woman in labor arrived, the emergency suspension orders released by the S.C. Department of Health and Environmental Control said.

Wilson and Kuschner could not be reached for comment Wednesday afternoon.

The woman, who arrived about 9:43 p.m. Aug. 29, was 8 centimeters dilated by the next morning, according to a 7:15 a.m. exam, the documents said.

But the woman was not checked again until 12:45 p.m., at which time it was discovered that the woman had “experienced a rupture of membranes with light meconium stained fluids,” the state documents note. No physician was consulted, the documents said.

Then between 6:05 and 6:53 p.m. Aug. 30, the baby’s heart rate dropped from the 130s to the 110s while in utero. Just before 7 p.m., the documents note that “oxygen was applied at 10 liters per minute via a face mask.” But no physician was consulted, the documents said.

Around 7:30 p.m., the midwives took the woman to the hospital in her own vehicle, without consulting a physician or calling for an ambulance, documents said.

The midwives contacted Piedmont Medical Center and told them they were “en route with a mother that has fetal intolerance to pushing, meet us downstairs,” documents said.

When they arrived, a cesarean section was performed, and the baby was born without a heartbeat. Hospital personnel tried to revive the baby but were unsuccessful, state documents said.

The documents noted that state law limits midwives to caring for those women who have been deemed low risk by a medical physician.

According to state law, midwives also must be able to recognize at all times the warning signs of a troubled pregnancy, the documents said. And as soon as they notice such signs, they’re required to contact a physician.

Midwives are also required to consult a physician if fetal heart rates continue to fall below acceptable levels, the documents said.

As a result, the department suspended both of the midwives’ licenses as well as the birth center’s on Sept. 2.

The center, which is just across the state line from Charlotte, has operated for four years. According to its website, it has five midwives on staff.

Monday evening, the center released a statement saying it is appealing the suspension, which stemmed from “a birth with a bad outcome.” The center referenced a “grieving family” but did not provide specifics.

It did say its midwives “took appropriate emergency measures in transporting the laboring mother to the hospital.”

The center claimed the state was enforcing a regulation that had never been previously enforced on any South Carolina birthing center – that a physician be on call and available to provide medical assistance at the birthing center at all times.

Mark Plowden, a spokesman for the S.C. Department of Health and Environmental Control, said the department would not make further comments on the license suspensions at this time.

On her staff profile, Kuschner said she has been a member of the midwifery profession since 1995.

She added that she completed her Master of Nurse Midwifery in 1998 at the State University of New York at Stony Brook and earned her certificate of midwifery in 1995 from The University of Medicine and Dentistry of New Jersey. She also received her bachelor of nursing from The College of New Rochelle, N.Y., in 1991, according to her profile.

Wilson’s staff profile notes that she has been a licensed midwife and certified professional midwife through the National Association of Registered Midwives since September 2011.

She also noted that she has a background in emergency medical services.