A teenage mother who died after giving birth to a much larger than expected baby should have been offered to be induced weeks before, an inquest heard today.
Slight-framed Teegan Barnard lost almost four litres of blood when she gave birth to her nine pounds and nine ounce baby via caesarean section after experiencing an obstruction during labour.
Within two hours of giving birth to son Parker, the 17 year old’s condition dramatically worsened and ‘her lips turned’ blue as she suffered breathing issues.
The first-time mother had suffered a devastating cardiac arrest and brain damage.
Today an inquest heard under NHS guidelines Teegan could have been offered induced labour at 38 weeks, three weeks before she eventually gave birth, but was not.
Pictured: Teegan Barnard and her baby Parker shortly after she gave birth. Within two hours of giving birth to son Parker, the 17 year old’s condition dramatically worsened and ‘her lips turned’ blue as she suffered breathing issues
Slight-framed Teegan Barnard (pictured with her mother Abbie Hallawell) lost almost four litres of blood when she gave birth to her nine pounds and nine ounce baby via caesarean section after experiencing an obstruction during labour
Teegan’s tragic last picture: Investigators from the Healthcare Safety Investigation Branch (HSIB) said it would have been ‘best practice’ and ‘appropriate’ for health workers to offer Teegan an induced labour, where a mother is given drugs to help kickstart a birth
Investigators from the Healthcare Safety Investigation Branch (HSIB) said it would have been ‘best practice’ and ‘appropriate’ for health workers to offer Teegan an induced labour, where a mother is given drugs to help kickstart a birth.
Instead, Teegan’s baby son grew in size and ‘in retrospect it would have contributed to the risk of Postpartum (after birth) haemorrhaging’, investigators said.
Just two hours after delivering her healthy baby – who weighed more than four kilos – Teegan suffered unsurvivable brain damage.
The teenager – who was pictured cradling her newborn in hospital in what are her tragic last photos – was looking forward to becoming a parent and would have been a ‘fantastic mother’, her family said.
Teegan suffered the cardiac arrest on September 9, 2019, at St Richard’s Hospital in Chichester, West Sussex, and died at home in Havant, Hants, on October 7, 2019, after being discharged to spend her final days there.
Today, as her four-day inquest opened at West Sussex Coroner’s Court in Chichester, her family described her as a ‘girly-girl’ who loved spending time with friends and horse riding.
‘Teegan had a big personality and was full of life’, her mother Abbie Hallawell said. ‘She loved her family and had close relationships with her grandparents.
‘She was girly-girl who enjoyed socialising with her friends and horse riding. Growing up she was a normal healthy girl who didn’t suffer any major illnesses.’
She added: ‘She was booked in to have her labour induced on September 9 but on the 7th began to have contractions so went to St Richard’s, she was checked over but midwives said she wasn’t dilated enough so sent her home.’
Ms Hallawell said the following day her contractions ‘escalated’ and she re-visited hospital. She was 4cm dilated but didn’t appear to be dilating sufficiently.
Her contractions became ‘very strong and she was in a lot of pain’.
Around 1am on September 9, Teegan showed signs of infection and was given an emergency caesarian. At 3.04am Parker was born 9lbs 9oz.
Teegan was ‘really looking forward to becoming a parent’, her mother said
However, Ms Hallawell told how doctors told her Teegan ‘suffered a bleed and cardiac arrest’. Subsequent scans showed she suffered brain damage.
Ms Abbie Hallawell and Teegan’s father Trevor Barnard have instructed expert medical negligence lawyers as they demand answers at the inquest.
Teegan was given ‘lots of support’ by midwives throughout her pregnancy. Midwife Sally Walters, who cared for her from eight weeks, said: ‘When I was looking after her I was not expecting a big baby.’
At St Richard’s Hospital, at 41 weeks pregnant, Teegan lost 3.8 litres of blood during childbirth in what is known as Postpartum haemorrhaging (PPH) in medical terms.
According to NHS Inform, blood loss is normal during childbirth however it is considered ‘heavy’ if more than 500ml is lost within the first 24 hours.
Teegan suffered obstructed labour – when a baby cannot exit the pelvis – and was given a C-section as well as being given two units of blood.
Matt Mansbridge, lead investigator for HSIB, said: ‘Teegan was bleeding, there was a major haemorrhage which was treated. She remained under general anesthetic.
‘The haemorrhage was managed in line with guidance, there was a calm atmosphere in the medical room.’
After, while doctors moved her to a bed, they recognised her condition had deteriorated.
Mr Mansbridge said: ‘A bed was requested and she was transferred to that… While rolling her, on the second roll, it was recognised there was an issue with ventilation.
‘Her lips turned blue and the alarm sounded on the ventilation machine.’
At 38 weeks Teegan visited St Richard’s and could have been given the chance to be induced by hospital staff but wasn’t.
Debbie Laing, maternity investigations team leader at HSIB, said the baby ‘would have been smaller’.
‘That’s the only thing that may have had a causal affect on the outcome’, she said.
‘The significance of [not being offered induction at 38 weeks] is that the baby had an opportunity to grow and increase the risk of Postpartum haemorrhaging.
‘We are able to say it would have been best practice to offer the induction earlier. It would have been down to Teegan and her family to make a decision as to whether it would have been done.’
She added it would have been ‘appropriate’ to have made a decision to offer induction at 38 weeks.
Ms Laing said: ‘What we know with retrospect is that the baby grew and that would have contributed to the risk of PPH.
‘What we [wouldn’t] know at that time is that it was going to happen.’
Ms Laing said it was ‘unpredictable’ that Teegan would suffer PPH when she was seen by midwives at 38 weeks.
She also said the baby’s wellbeing is the primary consideration when deciding whether or not to offer induced labour, rather than the mother’s.
Lawyer Adam Walker, representing Teegan’s family, suggested that, at 38 weeks, it would have been ‘forseeable’ that the baby would have been greater than 4kg.
HSIB said it made a safety recommendation to ensure induction of labour is offered appropriately.
The inquest also heard Teegan may have had an underlying infection which contributed to a raised temperature and may have suffered anaphylaxis during childbirth.
Teegan vomited at 11pm on September 8, 2019, shortly before her labour in the early hours of September 9, and her pulse raised to 119 beats per minute.
In a tribute, Teegan’s mother Ms Hallawell said: ‘Teegan and the rest of the family were delighted when she fell pregnant. She was really looking forward to becoming a parent and she would have been an absolutely fantastic mum.
‘It still doesn’t seem real that what should have been the best day in Teegan’s life ended tragically and left all of our family changed forever.
‘It’s been more than two years since Teegan died but time has stood still for all our family.
‘Teegan would have been so proud of Parker and how he’s such a happy baby who’s developing every day. While he’ll grow up without his mum in his life he will always be told how much Teegan loved him and how she’ll always be a part of our family.’
Teegan’s parents are bringing up Parker – who is now two – alongside his dad, Leon Forster.
The inquest continues.