12 Jul 2023
A Victorian midwife is banned from practising for three months and will be prevented from working in private practice for three years following a tribunal outcome relating to high-risk homebirths.
The Victorian Civil and Administrative Tribunal (the tribunal) found three allegations against Ulyana Kora proven which related to her role in two homebirths in October 2018 in which Ms Kora attended as the second midwife along with Martina Gorner who at the time of these events was registered as a midwife but is no longer.
Between 24 September 2018 and 10 October 2018, Ms Kora was involved in a woman's antenatal care, labour and homebirth. The woman experienced complications, which suggested the baby’s health was compromised. The woman attended hospital, but later discharged herself against medical advice. Ms Kora was aware of the complications and the circumstances in which the woman had discharged herself from hospital.
On 10 October 2018, after the woman went into labour at home, Ms Kora attended shortly after the birth of the baby, with Ms Gorner already in attendance. The baby was born in a poor condition and required immediate resuscitation, which Ms Kora assisted with. When paramedics arrived, Ms Kora (with Ms Gorner) requested them to wait five minutes before taking the baby to hospital.
On 19 October 2018, Ms Kora attended the homebirth of a second woman who gave birth to twins. Ms Kora had no previous knowledge of the woman or her pregnancy and failed to obtain adequate information, identify and/or address risk or adequately discuss or plan the care of the woman. The woman, who had declined any ultrasounds or testing and was thought to be in premature labour. Ms Kora attended the woman’s home as the first baby was being born (Ms Gorner was not yet in attendance). Ms Kora failed to call an ambulance at various points, including when it was understood the woman was in premature labour, after the first baby was born, who was thought to be premature, and not for thirty minutes after the arrival of the unexpected second baby who was in respiratory distress. Ms Kora also failed to keep adequate contemporaneous clinical records in respect of the decision making and/or recommendations and midwifery care provided to the women and their babies.
The matter was referred to the tribunal in 2021 and on 28 April 2023, the tribunal found that Ms Kora had engaged in professional misconduct as she had provided sub-standard care in relation to the two homebirths. In the tribunal’s view, 'Ms Kora’s misplaced reliance upon Ms Gorner was a dereliction of her duty and responsibility as a midwife. Whilst Ms Kora was the designated second midwife for each homebirth, this does not diminish her professional responsibility to the women in her care.'
The tribunal also found Ms Kora failed to maintain appropriate professional indemnity insurance in related to her practise as a private midwife.
The Nursing and Midwifery Board of Australia (NMBA) had sought cancellation of Ms Kora’s registration, a disqualification period of six to 12 months and a prohibition order for the same period. The tribunal ordered that she be reprimanded and suspended from practising for three months. Conditions were also imposed preventing her from practising as a private midwife for three years and requiring her to undergo further education and attend for mentoring.
The full decision is published on Austlii’s website.