Expert pokes holes in midwife's handling of high-risk births

STEVE Biko Academic Hospital head of the gynaecology department Professor Priya Soma-Pillay has accused now former Pretoria midwife Yolande Maritz Fouchee of not paying attention to the risk factors of several of her clients

Fouchee is facing 14 charges, including one of culpable homicide and several charges of assault after a baby died weeks after delivery and three others were born disabled while she was in charge of delivering them.

Fouchee, now a deregistered nurse, earlier denied any wrongdoing and explained that she did everything according to the book when she delivered the babies. 

However, Soma-Pillay disagreed in a statement issued to the prosecution as an expert witness to shed light on the treatment of Fouchee to the women who chose to have “home births” at her clinic. 

Soma-Pillay analysed the pre-labour and labour treatment of each of the four women by using Fouchee’s clinical notes.

She noted that some of the patients who attended Fouchee’s You&Me birth clinic were high-risk patients. Fouchee, according to the expert, did not pay attention to the risk factors of these patients.

She stated that patients who had previously delivered their children via cesarean section are classified as high risk, particularly during the time of labour and delivery. 

Soma-Pillay said they should have been informed of this risk, as well as the risk of uterine rupture during labour, which can result in adverse outcomes for both the mother and the child. Labour and delivery must therefore be managed in a facility which is equipped to manage complications, she said.

One of the charges Fouchee is facing is that she gave the mothers a substance to hasten labour, without informing them what the substance contained. Several women testified that they were given “water with rescue remedy” to drink, which shortly afterwards led to severe contractions.

The prosecution claimed that the substance is known as the abortion medication Cytotec. 

Soma-Pillay said this substance is extremely dangerous and should only be administered under strict doses. According to her, it is also dangerous and unheard of to administer this substance during active labour.

One of the mothers earlier testified that her daughter Sophia was born in July 2019 with cerebral palsy. She is blaming Fouchee for her child’s condition. Fouchee, in turn, claimed that the child was born this way because the mother had a bladder infection while she was pregnant and she refused to take antibiotics to clear it up.

The court was told that baby Sophia was blue in the face when she was born and that she had to be resuscitated for about 20 minutes before she could breathe normally.

The court heard that Fouchee handled between 16 to 24 deliveries a month at her You&Me delivery centre in Pretoria East, for which she charged from R16,000 upwards per delivery. Another charge Fouchee is facing is that she called her daughter in to assist her with the deliveries. Her daughter, the prosecution said, does not hold any medical qualifications.

The culpable homicide charge against Fouchee follows the death of a baby, born in 2020, who had died within weeks of birth. Another charge relates to a baby boy born with cerebral palsy and visual impairment. It is claimed that Fouchee was unable to deliver the baby and refused to transport the mother to hospital, where she could give birth via an emergency C-section.

It is claimed that Fouchee instead used forceps in an attempt to deliver the baby, despite the pleas of the mother that she wanted to go to hospital instead. It is alleged that her actions during labour resulted in oxygen deprivation to the fetus, causing injury to the brain.

The trial continues with Fouchee expected to later take the stand in her defence.

Cape Times