Access to free medico-legal advice is an important benefit that your insurance with MIGA provides you. Don’t forget to call us for assistance. Often you may know the answer but we are here to provide assistance and reassurance that you are on the right path and ensure that you understand and can deal with any medico-legal issues that may arise.

rocky-relationships

Many midwives have called us to ‘trouble shoot’ scenarios arising from their daily interactions with their clients. Recently we had the opportunity to assist two midwives who found themselves in complicated situations:

Scenario 1

A midwife rang to discuss her worries about recent interactions with a woman who was 28 weeks pregnant with her third child.

There were concerns about the woman’s mental health, however, she had refused to see a general practitioner, psychologist or psychiatrist.

The pregnancy was described as ‘tricky’. The woman had placenta previa and was to give birth by caesarean section. She understood and was accepting of this.

The woman was not coping well with this pregnancy and her husband was working away from home at the time.

The following options were discussed and considered:

  • Calling a mental health team to assess the woman
  • Calling an ambulance for transfer to hospital for assessment
  • Continuing to engage with the woman to support and encourage her to accept medical input.

The midwife was concerned with the first two options and the ramifications for her relationship with the woman and it was agreed this level of intervention was not required at this time.

It was agreed that as a first line strategy the midwife would meet with the woman (and if possible her husband) and talk through the benefits of increased medical support to ensure the best possible outcome for herself, her unborn child and her family.

The most important aspect of this discussion with the midwife was the documentation required in a case such as this one. Comprehensive notes on discussions, advice and outcomes is essential.

Scenario 2

A midwife called seeking advice on her rights and obligations for ending the professional relationship with a client. The woman was 36 weeks pregnant with a significant history of pre-eclampsia in a previous pregnancy. The woman intended to birth at home and also had ideas about inducing labour at 36 weeks.

The midwife was extremely uncomfortable with this decision and firmly believed this would put the life of the mother and the baby at risk. The midwife considered that the mother should birth her baby in hospital.

The woman had sent the midwife a very ‘nasty’ email making a number of unfair and incorrect accusations about the midwife’s care.

Our advice was that clearly the relationship had broken down and that it was entirely appropriate to terminate the care.

We provided advice and reassurance on the appropriate process to terminate the relationship.   View the Fact Sheet covering this topic below.

If you need advice, guidance or reassurance about any difficult client interactions we encourage you to call and discuss it with one of our experienced solicitors.

You may find a different perspective very beneficial and we are here to help you.

Other resources

  1. Fact Sheet

    Terminating the midwife-woman relationship.

Prefer to read a PDF of the Bulletin? Download it here

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