Stillbirth: Aberdare mum's 'unforgiveable' two-year wait
- Published
A grieving mother's two-year wait for a report into failings when she had a stillborn baby caused "trauma and anger", she has said.
Hayley Ryan lost her son Zaiyan at 30 weeks after being admitted to Merthyr Tydfil's Prince Charles Hospital.
A Cwm Taf Morgannwg health board report said her discharge from hospital in 2020 was "inappropriate", but Hayley said the findings have come "too late".
The health board has apologised for "delays and miscommunication".
Hayley, from Aberdare, Rhondda Cynon Taf, went to hospital on 9 June 2020 with vomiting and abdominal pain and was discharged the next day, despite not wanting to leave.
She said she "knew something was wrong" but felt "brushed off" by medical staff.
Zaiyan was stillborn when she returned to hospital two days later.
"I was just asking what happened to my son and why did it happen," she said.
Two years on, an internal report has found Hayley's discharge was "inappropriate", as was leaving her medical review to a community midwife.
It said she should have been advised to return to hospital for an obstetric review and repeated blood tests.
The case also showed "unclear clinical medical leadership" of a high-risk pregnancy because nothing was done about abnormal blood test results.
It concluded one of the "root causes" of the stillbirth was a missed diagnosis of acute fatty liver in pregnancy, external.
Hayley feels the wait for that information had "added to my trauma and my anger".
"We were phoning the hospital, we went over the hospital... but no phone calls back, no letters... like they didn't care," she told Wales Live.
The health board apologised for the length of time the report has taken and for "miscommunication throughout the process".
"There has been a delay due to clinical commitments by the clinicians to undertake the review which was exacerbated due to Covid," it said in its report.
It also said getting external input took time.
Director of midwifery, Suzanne Hardacre, said: "The loss of a baby is deeply tragic, and we apologise to Hayley and her family for any anguish caused by delays in communication.
"Our maternity and neonatal services teams have undertaken a period of significant improvement in recent years, but we acknowledge that there is always still more work to be done.
"We continue to encourage Hayley and her family to make contact with us directly so that we are able to discuss their concerns further."
The health board's maternity service was taken out of special measures last month.
New legislation proposed by the Welsh government would introduce a "duty of candour" on NHS organisations designed to "promote a culture of openness and transparency".
When patients "suffer harm", the health minister Eluned Morgan said at the launch of a consultation, external, "it is vital people receive a timely apology, receive an honest explanation about what happened, and action is undertaken to find out why that harm happened".
The public services ombudsman for Wales, Michelle Morris, welcomed the new legislation, which she said would allow staff to bring forward an issue even when patients had not complained.
"It allows the trust or the health board to identify things which may have gone wrong and to try and put them right earlier on, not just wait for a complaint to come in."
She added that a two-year wait for a report was "at the extreme" and said delays had a broader impact as well as causing distress for people.
"The longer it takes to conclude a complaint, the longer it takes for the learning to be embedded in working practices."
Hayley said she hoped measures were put in place so patients are "listened to more".
Wales Live, BBC One Wales, 22:35 GMT on 7 December
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