An unregistered midwife – Caitlyn Collins – and the Western Cape Health MEC Nomafrench Mbombo are being sued for nearly R5m by a couple who lost their twin babies in traumatic birth circumstances.
The couple is claiming R4.46m for emotional, psychological and financial damages, reports the Mail & Guardian.
Ernesta Chirwa and Chifundo Bingala have also filed a criminal case against Collins, who previously ran a business with colleague Ruth Erhardt called The Circle of Elephants, which the Western Cape Department of Health had ordered them to close in June 2021.
This was after a doctor at Mowbray Hospital reported Collins to the CEO of the institution when another set of parents had lost a baby, after allegedly being in her care during pregnancy and labour.
Western Cape police spokesperson Wesley Twigg said the case was still under investigation and that there were no new developments.
However, Collins, who has filed her intention to oppose the civil matter, has denied in court papers that she ever purported to be, or advertised professional services as a midwife, saying she presented herself as a “traditional pregnancy and birth care attendant/birth keeper”.
She said she had only offered Chirwa and Bingala “emotional support, birthing education and physical support in the form of massages”. But the M&G has seen several adverts and documents in which she claims to offer midwifery services.
Collins admitted in court papers that there had been one other baby which was stillborn under her care but blamed its parents for not seeking medical treatment on her advice.
She also admitted she was not a qualified nurse and that she had obtained a practice number from a traditional healer and not from the South African Nursing Council.
Chirwa and Bingala told the M&G that apart from the emotional and psychological pain and loss of income after losing their twins on 15 February 2022, they are seeking justice to stop Collins from working with other pregnant women to prevent further deaths of babies.
Chirwa said that Collins, under whose care she had been during most of her pregnancy, failed to provide the necessary medical care and advice, and did not identify that she was having twins, despite the size of her abdomen and the fact she had a family history of twins.
She also allegedly advised the couple not to have ultrasounds, did not measure the pregnant woman’s abdomen or regularly monitor the babies’ heartbeats during labour.
Chirwa said she had notified Collins at 6pm on 14 February 2022 that she had gone into labour but the latter had only arrived at the couple’s home well after midnight.
“She asked me how I was doing – she massaged my tummy, which is when she said: ‘I can feel the baby’s head is down’. And then she sat on the couch and slept,” Chirwa said.
She said her husband woke Collins at around 2am, who used a torch to examine her, which revealed the gestational sac was emerging.
She then allegedly fell asleep again.
Chirwa said her husband, concerned that the gestational sac was still hanging out, awoke Collins at around 5am.
“He said: ‘I think we must go to the hospital because it seems as if nothing is happening,’ and she switched on the torch and touched the sac and said: ‘Oh no, this is breech labour because the foot is coming out with the sac as well. I have never delivered breech labour before.’
“When my husband said I needed help, and that I should go to the hospital, she said: ‘We can wait a bit’,” Chirwa said.
However, Bingala insisted that Collins take his wife to hospital, so she allegedly dropped them at the entrance of Retreat Day Hospital, in Cape Town, without saying anything to the duty staff.
She also allegedly told the couple not to tell the staff they had attempted a home delivery.
However, Retreat Day Hospital does not have facilities to perform a Caesarean section and the couple had to wait for an ambulance to take them to the Mowbray Maternity Hospital’s obstetric unit, where the twins were stillborn.
One of the twins was still alive for at least 60 minutes while they waited for the ambulance.
Chirwa’s attorney Wayne Coughlan said Collins had “falsely held herself out to be a qualified and registered midwife who advertised and charged a fee for her midwifery services”.
Coughlan said at 14 weeks’ pregnant, the couple had trusted Collins to manage the pregnancy “ante-natally, to provide medical advice and supervision and to render appropriate obstetric care throughout the … pregnancy and through all stages of her labour, as well as during the post-partum period … and to deliver the baby/ies safely and, if possible, by means of a midwife-led home birth”.
He said by accepting Chirwa as a patient, and by virtue of the “doctor-patient relationship”, Collins had “a legal duty to take reasonable care and to avoid the risk of harm” to the couple and their unborn babies.
Coughlan highlighted a slew of alleged medical failures on Collins’ part which culminated in the twins being stillborn after a high-risk 43-week pregnancy.
“She failed to provide appropriate and quality medical and obstetric care and advice to the plaintiffs, and failed to act without negligence, and with the skill, care and diligence that could reasonably be expected from a caring, qualified and registered midwife in the circumstance,” he said.
“The medical advice and obstetric care that was rendered … was of a shockingly poor standard and she acted in such a reckless and grossly incompetent, unprofessional, uncaring, and reprehensible manner, that the first plaintiff was denied almost all of the basic obstetric care that could and should have been rendered by a midwife in the circumstances.”
Regarding the claim against MEC Mbombo, Coughlan said she should have been aware in 2020 and 2021 that Collins and Erhardt were running The Circle of Elephants midwifery practice.
Coughlan said apart from sending Collins a notice to shut down the business, Mbombo should have taken further steps to prevent her from practising as “an unqualified and unregistered midwife”.
She should have opened a criminal case with the police, reported her to the South African Nursing Council, the Health Professions Council of South Africa and to the Office of Health Standards Compliance.
“The death of the plaintiff’s unborn twins was as a direct result of the second defendant’s breach of its legal duty and which resulted in the plaintiffs suffering the injuries as set out,” Coughlan said.
But Collins has denied the raft of allegations, claiming the couple had not wanted to seek medical care at a public facility during the pregnancy.
She had advised them “on numerous occasions to open a folder at a local clinic” where she “could receive medical care for her pregnancy”.
Collins said at no stage had she purported to be “a registered doctor, a registered midwife or a registered nurse” or “provide any kind of medical, nursing or midwife care”.
She had not undertaken any medical examinations, ultrasounds, blood tests or any other medical, nursing or midwife-related tests. Collins also denied running The Circle of Elephants as a midwifery practice.
She asked the court to dismiss the claims against her, with costs, and that judgment be entered in her favour, with costs.
Her attorney Jody Blount said “the nature of the allegations … requires sensitivity”, while Mbombo’s spokesperson said the department could not comment on “ongoing legal matters”.
South African Nursing Council registrar and chief executive Professor Ntombifikile Mtshali said midwives must be registered with the council to practise legally.
“Every midwife must be registered to practise in South Africa and maintain the licence to practise by paying the annual practice fee.” She said Collins and Erhardt were not registered on the council’s database “which could mean they are not registered with the (South African Nursing Council)”.
She said she would need an identity number to verify this.
However, the M&G has seen earlier correspondence in which the council categorically states the pair was not registered with it.
Mtshali said the council had not received any complaints against Collins and Erhardt.
Mail & Guardian article – ‘Midwife’ sued after twins die (Restricted access)
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