Hope parents open up about tragic loss of unborn daughter

Nikki Tarran was due to give birth to her daughter Rosie in 2014 and had been preparing for her arrival with her husband David.

She said she had been to Wrexham Maelor Hospital for an appointment the week before her planned caesarean section and had raised concerns about the slowing movement of her baby.

It was later discovered her daughter had died.

Mrs Tarran, 34, described the difficult time which followed.

She said: "The doctor came with the ultrasound machine but couldn't find her heartbeat.

"It just came as such a shock because we were so prepared for her coming.

"I was really depressed and I had a breakdown. I didn't leave the house for a long time and I had to leave my job.

"When I go back to the hospital now I have panic attacks."

The couple believed they had not been listened to regarding their concerns and submitted an official complaint with Betsi Cadwaladr Health Board, which was also followed by an Ombudsman investigation.

Mrs Tarran's complaint to the Public Services Ombudsman for Wales focused on the management of her pregnancy.

In particular her complaint stated she should not have been discharged when she attended the hospital in pain and concerned about her unborn child, staff should have intervened earlier and delivered her baby sooner and had they done so, she considered that the outcome would have been different and her baby would have survived.

At the conclusion of the investigation the Ombudsman announced Mrs Tarran's complaint had not been upheld.

A report from the Ombudsman stated: "Mrs P (as Mrs Tarran was anonymised in the document) was found to have received appropriate clinical care throughout her pregnancy through a joint obstetric and diabetic clinic in accordance with national guidance.

"The Ombudsman agreed that Mrs P should have been seen earlier that day for proper assessment and had not been as the ward was very busy.

"This was a record-keeping concern and a staffing issue.

"He was concerned that some mechanisms be put into place in that regard to ensure patients such as Mrs P did not suffer such delays in the future.

"However, there was no way of knowing when, why or what happened to lead to the sad, unpredicted outcome for Mrs P.

"There has been no clinical indication for any earlier intervention or delivery as Mrs P had complained."

Despite not upholding the complaint, the Ombudsman made recommendations to Betsi Cadwaladr University Health Board.

These were that the health board should undertake a review of staffing levels on the ward in question to ensure there are minimum safe staffing levels at midwife level and also a sufficient doctor presence, in the event that deficiencies are highlighted it should also provide the ombudsman with an action plan as to how it proposes to ensure minimum staffing levels are maintained.

The other recommendations were that the director of nursing should undertake a sample review of midwifery record-keeping on the ward to assess that they are in line with NMC (Nursing and Midwifery Council) standards and a report on the outcome of the review should be provided within one month thereafter.

All of these recommendations, the Ombudsman stated, were agreed to in full by the health board.

In a letter to Mrs Tarran following the investigation, a health board spokesman said: "I would like to offer my unreserved apologies for the shortfalls and failings identified during the course of the investigation into the concerns you had raised in relation to the poor management of your pregnancy and antenatal care at Wrexham Hospital."

The spokesman assured her the Ombudsman's recommendations were in the process of being implemented and "lessons have been learned to help prevent something similar happening in future".

Despite the Ombudsman's findings however, Mr and Mrs Tarran said they still believe they were not listened to and had their concerns been addressed more quickly, doctors may have been able to act sooner.

Mrs Tarran said: "The movements had slowed down from about two weeks before that day and we were told it was just because she was getting bigger and had less room to move and we were really just not taken seriously.

"I wanted justice for her. If they had listened and checked sooner there might have been time to get her out."

Mr and Mrs Tarran have four other children - Rebecca, 15, Kyle, 13, Hanna, nine and two-year-old Emily-Rose.

The couple now hope to use their experiences to warn other women to ensure any concerns they have about their pregnancy are fully examined.

Mrs Tarran said: "I'm hoping to reach out to parents and encourage them to find out more about babies' movements - like the slowdown I experienced.

"It needs to be taken seriously and you just need to go and get checked out as soon as possible, because everything can change in a split second."

There also needs to be more support for parents - particularly dads - following the death of a child, the couple believes.

Mrs Tarran explained: "When it happened, we didn't have counselling or anything.

"Then when I did get help, it was only offered to me and not David.

"I don't think fathers are thought about enough, but they go through it just as bad."

Mr Tarran said: "I had to look after my wife and make sure she was ok, but she was getting some help too. I was getting none.

"Dads need more support."

The Leader contacted Betsi Cadwaladr University Health Board to ask what improvements have been made since Mrs Tarran's complaint, as well as to explain what support is available to parents who find themselves in the position she and her husband were in.

A health board spokesman said: "We have robust systems in place to ensure safe levels of staffing on our maternity wards which comply with national standards.

"In the sad event that a baby dies during or shortly after pregnancy, we have a range of services in place to ensure parents receive the support they need.

"We recently appointed a bereavement midwife who provides dedicated care to families, which supports the bereavement pathways we have already had in place for a number of years.

"Dedicated bereavement facilities have also been developed at Wrexham Maelor Hospital, Glan Clwyd Hospital and Ysbyty Gwynedd."