Annual Report for the year ended 30 June 2009 - Health and ...

REPORT OF THE DIRECTOR OF PROCEEDINGS
MIDWIFE FOUND GUILTY OF PROFESSIONAL MISCONDUCT
This case concerned the care provided by a midwife, Ms Monique Kapua, to a first-time pregnant woman
(Ms C). Ms C gave birth to a stillborn baby boy, following a prolonged pregnancy of 43 weeks.
On 22 June 2009 the Health Practitioners Disciplinary Tribunal found that Ms Kapua’s conduct amounted
to malpractice and negligence and in many instances her conduct amounted to acts or omissions that
would bring discredit to the midwifery profession.
Ms Kapua failed to:
• provide Ms C with relevant information about standard midwifery tests and examinations
• undertake sufficient standard midwifery tests and examinations
• provide Ms C with relevant information about the risks involved in prolonged pregnancy or the
induction process and the reasons for induction
• provide Ms C with information about access to, and choices of, obstetric and secondary care
• recommend to Ms C that a consultation with a specialist was warranted and/or make adequate
arrangements to ensure that this was done
• provide adequate handover of care of Ms C in that she spoke to another midwife but failed to arrange
for her to see Ms C in her absence; and/or provide her with her client’s records
• arrange for appropriate assessments for a prolonged pregnancy to be undertaken
• adequately and/or accurately document the care she provided to her client between 1 January 2006
and 5 October 2006.
The Tribunal stated:
“A lot of the emphasis in this case was placed by Ms Kapua on the fact that Ms Kapua had, in addition
to her midwifery practice, an emphasis on traditional Māori aspects of birthing. There was some
suggestion that this Tribunal hearing might be a challenge to those practices. It is certainly not a
challenge of those practices. Ms Kapua appears before the Tribunal in her role as a registered midwife
and in that role has the obligations of a reasonably competent midwife to carry out all of the tests
and analysis required by midwifery standard and to gather and document that information which
is regarded as being standard care for midwives. Ms Kapua’s Māori Tikanga should be an additional
(and desirable) part of her practice, influencing her care but never allowing it to mean that any
women receives a substandard level of care. Tikanga Māori is an enhancement to safe practice, not a
detriment to it.”
The Tribunal further stated that Ms Kapua would not be guilty of professional misconduct simply
because she had adopted the practice of traditional Māori midwifery. The Tribunal confirmed that what
was being judged was the practitioner’s level of conduct against the level of other reasonably competent
midwives whether they be Māori midwives practising Tikanga Māori in addition to their midwifery
practice or Pākehā midwives or midwives from other ethnicities. What was not being judged here was
traditional Māori birthing practice.
See: www.hpdt.org.nz/portals/0/mid08103ddecdp070anon.pdf
22 E.17