A coroner has issued a formal warning about the potential risks of doulas interfering with the professional duties of midwives, following the tragic death of a baby girl just two weeks after her birth. The caution comes after an inquest into the case of Matilda Pomfret-Thomas, who passed away in November 2023 due to brain damage caused by oxygen deprivation.
Coroner's Findings on the Home Birth Incident
Henry Charles, the coroner for Hampshire, Portsmouth and Southampton, conducted the inquest last month and highlighted significant concerns. Matilda's parents had opted for a home birth, hiring a doula for emotional support after a previous traumatic hospital experience. During labour, complications arose, including the presence of meconium and decelerations in the foetal heart rate, which midwives noted as signs of distress.
Impact of the Doula on Medical Care
Coroner Charles stated that the doula negatively impacted the midwives' ability to provide advice and standard care to the mother. He described a difficult atmosphere where midwives felt their access was restricted by the doula, who acted as a buffer between them and the parents. Despite two recommendations from midwives to transfer Matilda to Queen Alexandra Hospital, these were ignored, and the mother was not taken to the hospital until hours later.
The coroner noted that the doula was following the birth plan and supporting the parents, which may have fostered false hope that a home birth was still viable. Matilda developed the condition over a period of hours while her mother was in labour at home, he explained, emphasising the critical window for medical intervention.
Broader Controversy and Regulatory Gaps
This case underscores the ongoing debate around doulas, who are unregulated and non-medical professionals. While organisations like Doula UK have membership and training requirements, the role remains contentious. Some advocate for doulas as essential emotional supporters, but others, including medical professionals, warn they can pose risks to maternal and infant health.
Coroner Charles concluded by calling for a review of doula registration, regulation, and training to prevent similar tragedies. The issues of doula registration, regulation and training are therefore points of concern I would commend for review, he said, urging authorities to address these gaps in oversight.
This incident serves as a sobering reminder of the complexities involved in childbirth choices and the need for clear communication and collaboration between all parties involved in maternal care.
