Jennifer Cahill, 34, delivered baby Agnes at her home supported by her husband Rob and two midwives in June last year. She had opted for a home birth after feeling ‘unsupported’ in hospital while delivering her son three years earlier, her partner said
A mum died just days before her baby daughter after giving birth at home, an inquest has heard.
Jennifer Cahill, 34, died the day after welcoming second child, Agnes. The baby girl lived for four days before she also passed away. The tragedy unfolded on June 3, 2024, at the family home of Jennifer and Rob Cahill in Prestwich, of Bury, Greater Manchester .
Following their deaths, Jennifer’s choice to have a home birth was described as ‘out of guidance’ and ‘against advice’ by hospital trust staff, because of concerns stemming from the birth of Jen’s first child.
But her husband Rob told the court he believes the phrases ‘out of guidance’ and ‘against advice’ were never raised directly with the couple throughout the pregnancy. “I never heard that terminology until after the event,” the risk analyst said.
On the night she went into labour at home, two midwives arrived to help Jennifer – and at first it appeared as if everything was going to plan.
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But as her contractions intensified, problems arose. The canister and tube supplying gas and air failed – and one midwife had to leave to get replacements, the hearing was reportedly told. Mr Cahill said his wife quickly became tired even though she thought she had planned every step of her labour and delivery. He added: “There was not enough pain relief. Jen became fatigued and lost her confidence.”
Mr Cahill told the hearing he had to call 999 at around 6.45am on June 3 when Agnes was born unresponsive and the nurse’s resuscitation attempts failed. Mr Cahill went to the hospital with Agnes. He was only told later that his wife was also being rushed to hospital after suffering complications.
The inquest, held at Rochdale Coroner’s Court, has not yet heard the causes of death for either Jennifer or Agnes. Rob said: “We held Agnes’ first and only birthday party as she neared the end. I held her and told her how much her mummy and brother loved her, and I said goodbye.
“When I think of Agnes, I’m just happy I got to spend any time with her at all, after everything that happened that week – she was our comfort, and I’ll never forget that.”
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Community midwife Caroline Nixon, who saw Jennifer the most during her second pregnancy, admitted in court that “an ‘out of guidance referral’ should have been made to a senior midwife” because of her high-risk status. Heartbroken Rob told the court that this might have prompted Jennifer to reconsider a home birth.
Jennifer, originally from Worcester, met her husband while in her final year at the University of Manchester in 2011. They married in 2018 and welcomed their first child in 2021.
But after giving birth, Jennifer had suffered a postpartum hemorrhage, losing more than 800ml of blood due to an episiotomy and tear and the fact that her firstborn was a large baby. She required a blood transfusion and, as a carrier of group B strep, faced the risk of passing the infection to her newborn.
Because of these complications, Jennifer was referred to a consultant at North Manchester General Hospital, run by Manchester University NHS Foundation Trust (MFT), to develop a delivery and treatment plan for her second child.
The plan, overseen by Dr Rice, advised Jennifer to have a “hospital birth” with “active management”, including a medication drip to reduce the risk of bleeding while delivering the placenta, the court heard.
Ms Nixon said she also discussed these risks with Jennifer during midwife appointments in December 2023. But by February 2024, Ms Nixon said Jennifer informed her she wanted a home birth.
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Rob said that the “traumatic” birth of her first child left Jennifer anxious about delivering a baby in hospital. She felt that having two midwives present at home could provide better support and a calmer environment for her second delivery, reducing stress for both her and the baby.
Of their previous experience, he told the hearing: “There was no one midwife assigned to Jen. There seemed to be lots of midwives coming and going. Jen did not feel she had been fully supported. It was a tricky time because of Covid and there were lots of restrictions.”
Ms Nixon said she followed trust policy by referring Jennifer to Dr El-Adwan, as “she was a high risk lady requesting a home birth”, which deviated from the first birthing plan. This included substituting injections for the recommended drip to prevent bleeding.
After speaking to the doctor, she said Jennifer remained committed to a home birth and Ms Nixon continued to “review the risks and plan with her”. But she added that she never specifically addressed that the choice to have a home birth was against medical advice.
Asked why not by Coroner Joanne Kearsley, Ms Nixon replied: “We were told we had to respect women’s choices” in training by the hospital trust. The trust would not say no to “any lady who wanted a home birth, so community midwives were becoming increasingly anxious about ladies being higher risk” which had been “raised verbally to senior leaders”, the court heard.
“All community midwives were concerned about high risk ladies having home births. That’s not what we were trained for. We were trained to look after low risk ladies in home births,” Ms Nixon said. “[The risk of death] wasn’t something you were ever told to talk about with ladies.”
Asked by the coroner if she thought Jennifer fully understood the risks, Ms Nixon replied “yes”. However, she admitted she should have referred Jennifer back to a doctor once she declined to be tested for group B strep, which can come and go from the bodies of carriers, since this was another decision regarded as ‘out of guidance’.
Rob said his wife’s medical notes throughout her pregnancy never mentioned the phrase ‘out of guidance’ regarding her choices or her birth plan.
“I was aware that the hospital’s preference was that she had a hospital birth, my understanding was that it was related to her being a strep B carrier in case that came up,” said Rob, regarding his conversations with Jennifer after her doctors’ appointments. “The emphasis was on the strep B, not postpartum haemorrhage.”
The Mirror has contacted the trust, who said: “We only provide comments/statements on inquests once they have concluded so that we may give consideration to all the evidence which has been heard and the Coroner’s ruling.”