WHEN Keeley Bevan stopped feeling her unborn baby moving, instincts told her something wasn't right.
The 29-year-old visited medics with her concerns but after being checked over she was assured everything was fine and sent home.
But tragically her baby Esmae died in the womb and delivered stillborn at 39 weeks.
The mum-of-three has blamed a series of "errors" at North Manchester General Hospital and accused nurses of being "insensitive" after her baby's death.
An internal investigation into Esmae’s death, carried out back in 2015, found that there had been a "failure to assess the risk of fetal demise and lack of appropriate action".
Bosses at Pennine Acute Hospitals NHS Trust, which oversees care at North Manchester, say lessons have been learnt since Esmae’s death and there have been "significant changes" in care since.
Maternity services have since been rated "good" – up from "inadequate" back in 2016.
A mother's instinct
Keeley, from Salford, accepts that changes have been made but is urging expectant mums to trust their instincts.
She said: "I didn’t feel strong enough until now to talk about it. But I need closure and I do want to give advice to other women.
“If they feel something is wrong they need to say.
"When I went in after they did the investigation they said all the nurses and doctors were going into training. The mother’s instincts need to be listened to more.”
I didn’t feel strong enough until now to talk about it. But I need closure and I do want to give advice to other women
Keeley visited the hospital twice – when she was 28 and 31 weeks pregnant – with concerns about low movement, and was checked over and sent home.
She returned on March 10 2015, when she was 39 weeks pregnant, because she was worried that she could not feel her baby moving.
Keeley was hooked up to a cardiotocography (CTG) machine and felt calmer when she heard the thump of the baby’s heart.
After half an hour, the midwife reviewed the progress, and asked if Keeley was happy for her to stop the monitoring.
But the mum said something was ‘nagging’ her and she needed to be sure her baby was okay.
She was further monitored and spoken to by a doctor who offered a sweep to try and start labour, which was unsuccessful.
A date was set for induction five days later, on March 15, and Keeley was sent home.
During a further scan, a radiographer was unable to locate the placenta but said Esmae looked fine and Keeley was sent home with a leaflet about induction.
In a moving blog post about her experience Keeley said: “I tried to sleep but I couldn’t shake the unease.
“Since getting back from the hospital she had gone quiet again.”
The following day, Keeley couldn’t feel her baby moving but "brushed it off" initially because of assurances she had received from medics the previous day.
She called the hospital and was advised to have a warm bath, go for a walk and lie on her side to try and get the baby moving.
Feeling panicked, Keeley and her partner went to hospital where she says she had to wait for an hour and 20 minutes for a scan.
I couldn’t take in what was going on. We were just shocked and devastated
After examining the expectant mum, a midwife asked for a doctor to give their opinion and was eventually told: ‘There is no heartbeat’.
“My whole world shattered in them four words,” Keeley wrote in her blog.
“It felt like a blur after that. My baby had died. Why had this happened? She was fine yesterday. I couldn’t take in what was going on. We were just shocked and devastated.”
As Keeley and her partner left the hospital she says she was angered by a nurse who told her, “Just think, everything happens for a reason.”
Esmae was delivered three days later on March 14, 2015, weighing 6lb 14oz.
An investigation by Pennine Acute Hospitals NHS Trust found that the placenta had failed.
A report into the death states that the three times Keeley had episodes of reduced fetal movements CTG was normal.
But when she reported that the quality of movements had changed on the third occasion, ‘this fact was not taken into consideration’.
The report states that this led to a delay of five days for induction of labour, which in fact could have been offered on March 10.
“The root cause was failure to assess the risk of fetal demise and lack of appropriate action,” the report states.
It adds: “Women’s perception of fetal movements is a very important indicator of fetal wellbeing and should not be undermined.
How often should my baby move in pregnancy?
Baby movements in the womb, also known as fetal movements or ‘kicks’, can feel like anything from a flutter, kick, swish or roll. The type of movement may change as your pregnancy progresses.
According to the charity Tommy's, there is no set number of normal movements you should be feeling – every baby is different. Your baby will have their own pattern of movements that you should get to know.
From 18-24 weeks on you should feel the baby move more and more. After 32 weeks, the movements will stay roughly the same until you give birth.
It is NOT TRUE that babies move less towards the end of pregnancy.
You should continue to feel your baby move right up to the time you go into labour and during labour.
Get to know your baby’s normal pattern of movements, they say.
And don't until the next day to seek advice if you are worried about your baby’s movements.
Contact your midwife or maternity unit immediatelyif you think your baby’s movements have slowed down, stopped or changed. There are staff on the hospital maternity unit 24 hours a day, 7 days a week.
Get more advice on the Tommy's website
"Once the decision has been made for delivery, it should be considered as a matter of urgency."
The report recommended that clinical guidelines for reduced fetal movements should be revised and staff should be "educated" about the importance of early induction for women with recurrent reduced fetal movements.
It also states that "there was a considerable amount of time that elapsed surrounding handover before the confirmation of fetal demise was conveyed to Keeley".
As a result investigators recommended that the timing for "conveying bad news surrounding handover periods to patients" was reviewed.
Keeley says she is glad that changes were made and hopes her experience means other mums "will be taken seriously" when they complain of reduced fetal movement.
But she believes that Esmae’s death was preventable and says she was "failed" by medics.
She became pregnant again shortly after losing Esmae and says she really struggled.
“I didn’t know how I would do it,” she says. “I was very nervous.”
Having suffered with anxiety ever since, Esmae stopped leaving the house because people would ask her when the baby was due.
She said: “That’s become normality for me now. I don’t leave the house unless I am with someone, which is very rare.
My life has changed so much – I used to be an outgoing person and now I don’t ever leave the house unless needed
"Also I don’t use public transport. My life has changed so much – I used to be an outgoing person and now I don’t ever leave the house unless needed.”
She added: “I have seen mums on Facebook groups saying they’ve not felt the baby move and I always comment and tell them to go to hospital and get checked over and if you still worried stay until you feel okay.”
Simon Mehigan, Divisional Director for Midwifery and Nursing at the Northern Care Alliance NHS Group, said: "We wish to offer our sincere condolences to Keeley and her family for the loss of their baby in 2015 at North Manchester General Hospital. Our deepest sympathy goes out to them.
"Following Esmae’s death, we undertook a thorough investigation into the care she received.
"The recommendations from this report, together with our commitment to the implementation of the Department of Health’s “saving babies lives” care bundle, has seen significant changes in the care we provide to women during pregnancy.
"These changes have resulted in a reduction in the number of families suffering the loss of a baby through stillbirth.
“Improvements to our governance processes, together with the strengthening of the leadership within maternity services, has led to us receiving a rating of 'Good' for Maternity services from the CQC in 2018.
"This reflects the changes that have taken place from the previous CQC inspection in 2016, when Maternity was rated 'inadequate'.
“A baby’s movements are an important indicator of their wellbeing and we would encourage women to contact their maternity care provider if they have any concern about themselves or their baby.”
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