Mia Pilbrow was just 22 weeks pregnant when she started bleeding and experiencing severe stomach and back pain.

Terrified she was losing her baby, she rushed to Alice Springs Hospital seven times over the next four weeks, begging doctors for help.

Mia says doctors first told her the bleeding was caused by a subchorionic hematoma, a blood clot that would disappear in a few weeks.

But her symptoms kept getting worse.

Hospital records show multiple clinicians missed signs that Mia was in labour, repeatedly sending her home and assuring her the baby was fine.

‘They just kept sending me home’

Hospital records show that over five days between May 8 and May 13, 2023, Mia sought help from Alice Springs Hospital, where she was spending almost every day.

On one occasion, she was kept overnight after CTG monitors picked up that she was having irregular contractions.

On another, scans revealed the length of her cervix had significantly reduced to 20 millimetres — a sign of early labour.

Doctors at one point considered transferring her to an interstate hospital better equipped to care for premature babies, but she was ultimately discharged.

“From 25 weeks I was still bleeding,” Mia said.

“I had abnormal fluids, lots of heavy discharge, cramping.”

“I kept going in there, spending hours on end asking [hospital staff] what’s wrong, concerned that my baby was not okay, and they just kept sending me home and telling me it was a subchorionic hematoma.”

Early in the morning of May 13, Mia rushed to the hospital for a seventh time.

She told staff she was having contractions, and was admitted to the delivery suite. But she says she was then left alone, despite ringing the alarm for help.

Mia, who worked as a radiology administrator at Alice Springs Hospital at the time, said she saw her baby was no longer in her uterus when a nurse eventually performed an ultrasound.

She said she could feel Ayla was in her birth canal, “but the registrar looked at me and said that everything’s fine”.

About an hour later, Mia’s waters broke.

Her daughter was born extremely premature, weighing just over 700 grams, in a critical condition and suffering a brain bleed.

Alice Springs Hospital is not equipped to care for extremely premature babies, and records show it took more than five hours for Mia and baby Ayla to be airlifted to the Flinders Medical Centre neonatal unit in Adelaide.

Mia said when her and her partner arrived, doctors told them Ayla likely would not survive.

What had been diagnosed as a grade 1 brain bleed at Alice Springs Hospital was actually a grade 4 bleed, which can cause significant brain damage.

“What hurts the most is knowing that Ayla would not have suffered such a devastating injury if I had received the proper evidence-based care — steroids, magnesium and an urgent transfer — that every other state in Australia mandates,” Mia said.

Monash Hospital obstetrician and maternal fetal medicine specialist Kirsten Palmer said steroids halved neonatal mortality and minimised brain bleeds in babies, and magnesium minimised the chances of cerebral palsy.

“What’s also important is being born in a hospital with a neonatal team with experience in caring for premature babies, and recognising when a premature birth is highly possible, it is important to transfer a woman to a hospital equipped for premature births,” she said.

Family taking legal action against hospital

Two years on, Ayla lives with cerebral palsy, learning difficulties and hydrocephalus — all conditions that Mia believes were preventable.

The NT is one of the only places in the country without its own pre-term labour guidelines. Instead, it relies on South Australia’s, which do not account for factors such as the territory’s remoteness, workforce shortages or limited access to specialist care.

Mia is now taking legal action against Alice Springs Hospital, and speaking out about gaps in hospital care in the NT.

She alleges there was a failure to recognise the severity of her symptoms and that there was no escalation of care to the on-call consultant.

“She is the happiest, most joyful little girl. She’s very cheeky, and always has the biggest smile on her face.”

The NT Health Department said though the territory’s pre-term labour guidelines were a copy of South Australia’s, they had been assessed as appropriate.

“Patients who present at a NT hospital with pre-term birthing needs are assessed and monitored according to these guidelines and provided with an individual care plan that focuses on maternal and foetal safety and wellbeing,” NT chief nursing and midwifery officer Kellie Wilton said.

She said the NT was strengthening its practices through participating in the Australian Preterm Birth Prevention Alliance, and by working in partnership with the National Preterm Birth Prevention Collaborative – a world-first pre-term birth program.

McInnes Wilson Lawyers principal lawyer Emily Billiau, who is acting on behalf of Mia, said the NT’s lack of tailored pre-term labour guidelines represented more than a policy gap.

“It poses a profound risk to the safety, equity and outcomes of women and newborns,” she said.

“We are not questioning the expertise of our healthcare professionals, but even the most capable teams perform better, safer and more consistently when they are supported by clear, streamlined guidelines.”

Ayla remained in the Flinders neonatal intensive care unit for about five months after she was born and underwent dozens of procedures, including five brain surgeries.

Mia is now Ayla’s full-time carer, spending the majority of her time taking her daughter from physiotherapy sessions to appointments with feeding and speech specialists.

Original source: AU