Mum was willing to risk baby's life

EXPECTANT mother Sarah Kerr told an obstetrician she was willing to risk the death of one of her twins by having a home birth, a court has heard.

EXPECTANT mother Sarah Kerr told an obstetrician she was willing to risk the death of one of her twins by having a home birth, a court has heard.

Women's and Children's Hospital obstetric registrar Dr Puvana Raman gave evidence yesterday at the inquest into the death last month of Tully Oliver Kavanagh.

Dr Raman told Deputy State Coroner Anthony Schapel that Ms Kerr, right, seemed to have ``made up her mind'' about having a home delivery. That was despite knowing the increased risk of giving birth to twins at home.

``She said she understood either twin could die and she wanted to accept that risk,'' Dr Raman said.

``I have not heard any mother say that she would be willing to accept the risk of a baby dying and not come to hospital because of that.''
He said Ms Kerr presented to hospital in July with gastroenteritis and required hydration. 

Dr Raman was in charge of her care and became aware that Ms Kerr and her husband Matthew Kavanagh were planning on a home birth.

Women's and Children's Hospital obstetric registrar Dr Puvana Raman gave evidence yesterday at the inquest into the death last month of Tully Oliver Kavanagh.

Dr Raman told Deputy State Coroner Anthony Schapel that Ms Kerr, right, seemed to have "made up her mind" about having a home delivery. That was despite knowing the increased risk of giving birth to twins at home.

"She said she understood either twin could die and she wanted to accept that risk," Dr Raman said.

"I have not heard any mother say that she would be willing to accept the risk of a baby dying and not come to hospital because of that."

He said Ms Kerr presented to hospital in July with gastroenteritis and required hydration.

Dr Raman was in charge of her care and became aware that Ms Kerr and her husband Matthew Kavanagh were planning on a home birth.

During the delivery of Ms Kerr's second child, she said she felt violated by a NSW doctor who performed physical manoeuvres on her, without her consent, to stem haemorrhaging.

She has had two single home deliveries prior to last month's incident.

Yesterday, Dr Raman said she was told of that negative experience but was advised by obstetrics consultant Dr James Harvey to again outline the risks involved with home birthing twins.

"(Ms Kerr) kept telling me she knew and had read up on the complications of a home birth," Dr Raman said.

"She came across as someone who had already made up her mind."

Dr Raman said she asked Ms Kerr about her ante-natal care and who her treating midwife and general practitioner was.

She said Ms Kerr replied that birthing advocate and former midwife Lisa Barrett had been advising her with her pregnancy, but that she didn't support the couple's decision to have a home birth.

"She said her midwife didn't support her twin delivery at home and she wasn't in favour of it," Dr Raman said.

Paul Kelly, for Ms Kerr and Mr Kavanagh, said his clients were not comprehensively informed of the options for a hospital birth and that submitting to an epidural, which Ms Kerr did not agree with, was the only alternative offered.

Mr Kelly alleged Ms Kerr was told she would "bleed all over the house" if she haemorrhaged during a home birth and that Dr Raman was going through the risks so the couple "wouldn't sue the hospital".

Tully died after his twin, Ruby, had been successfully delivered half-an-hour earlier on October 7.

When he did not follow immediately and his heart rate dropped, Ms Kerr, Mr Kavanagh and Ms Barrett transferred to hospital but Tully was born en route.

The inquest has previously been told that the risk of death is higher in twin births if difficulties are experienced during a home birth.

Yesterday Mr Schapel ruled he would consider Tully's death in conjunction with an ongoing inquest into the deaths of two other babies following home births attended by Ms Barrett.

In September, Mr Schapel heard closing arguments for the inquest into the 2007 and 2009 deaths of Tate Spencer-Koch and Jahli Jean Hobbs.

All three babies died after complications during home deliveries attended by Ms Barrett.

The inquest continues.