A MIDWIFE who says she was unfairly sanctioned after helping a woman give birth at home claims her case is an example of failures in the health system.

Krishinda Powers-Duff was called before the Nursing and Midwifery Council (NMC) due to an incident during lockdown where, despite having no insurance, she assisted a mother who was freebirthing - giving birth without the assistance of a midwife or other medical professional.

Krishinda had been asked by the woman to be present at the birth for moral support only, but when a complication arose she stepped in to assist and, she says, saved the baby’s life.

When an ambulance crew arrived, the midwife did not make herself known to paramedics but did, in the following days, report herself to her professional standards body.

She was called before the NMC without legal representation and without, Krishinda claims, having a fair hearing. She was given an 18 month interim order, which prevents her from working while an investigation takes place, and is now appealing this decision.

Campaigners say that Krishinda’s case is not unusual, claiming nurses and midwives are routinely sanctioned with little evidence or investigation by the NMC, and that there a crisis facing independent midwifery which is bad for midwives, and for mothers.

When Krishinda first began working at the Princes Royal Maternity Hospital in Glasgow she was impressed by her colleagues. She said: “There were skilled, fantastic midwives but there were problems with the system and after a while I felt I wasn’t helping.”

While England has independent midwives, Scotland had none, so Krishinda joined an English company, Private Midwives, and worked for them in and around Glasgow.

But Krishinda says she faced prejudice as a private midwife and struggled to work with NHS community midwifery teams but is not sure whether the prejudice was due to her race or because she was a private midwife - or both.

“It just really became quite emotionally unpleasant trying to support these women while having to fight an unwelcoming system,” she said.

A spokesman for the health board said: “We are sorry to hear this former member of staff had concerns regarding her time at NHSGGC.”

He said that there are “robust support measures and policies” in place to assist staff members to raise concerns, a process the NHS is “absolutely committed” to.

He added: “We can confirm there is no record of this member of staff raising concerns on these issues in relation to her experience at NHSGGC.”

Krishinda told her two remaining expectant mothers that she felt unable to deliver them, but would support them with post-natal care.

As coronavirus continued to spread, NHS home birthing teams were withdrawn and women only given the option to deliver in hospital.

But some mothers don’t want this - due to previous trauma, concern about over-medicalised births or fear of Covid-19 infection, for instance.

Krishinda, who trained in Bristol before working for nearly nine years as a midwife in Spain, said: “More and more women are choosing to freebirth because they don’t have any other choice.

“It can be really dangerous - but they don’t feel they have a choice and they don’t feel they are being respected. And they’re not.

“Midwives like myself who work in the system want to be able to give that kind of care but we’re made to feel bad or are bullied for it.

“Women’s rights are being violated and Covid-19 is being used as an excuse.”

THE NHS home birth service was suspended from March 19 to July 27 in line with government guidance.

Since the community home birth service was resumed, there have been 14 home births in Glasgow.

NHS Greater Glasgow and Clyde says it cannot provide a number for how many women chose to freebirth during the Covid-19 crisis as the figure is so small as to identify individuals.

One of Krishinda’s patients had asked the NHS for support from the home birth team but went into labour just two days before home births were re-started.

Glasgow Times: Krishinda Krishinda

When labour began, she tried to contact friends who had agreed to support her but, when she couldn’t reach them, called Krishinda who agreed to visit her home strictly for moral support.

However, the baby became distressed, so Krishinda asked the woman’s husband to call an ambulance and decided she had to help the mother deliver.

She said: “I did my job. By the time the ambulance arrived everything was fine. Baby was pink, mamma was fine, the placenta was out. But I just panicked. I just thought: I know exactly what’s going to happen.

“She went to the hospital and I went home. The next day I knew I had to let the NMC know what had happened.”

Meanwhile, Private Midwives also referred Krishinda to the NMC, adding a raft of allegations to the complaint against her - issues Krishinda claims had not been raised with her directly.

Eduard Sparkes, CEO of Private Midwives, confirmed that Krishinda worked for the company and said “numerous attempts” were made to work with and support her after a “number of incidents” occurred.

He added: “As a result, her clients were removed from her care to protect them. We collaborated with the local NHS and alternative, safe plans were put in place for all of them.

“At all times we have been open with Krishinda Powers-Duff and tried to support her to learn.

“Her continued contact with the media and social media to present a different version of events is not helping her case with the regulator and is disappointing.”

The midwife says she was initially told by the NMC she had 28 days to prepare her case but then was told her hearing would be in one week’s time.

A family friend, who is a lawyer, assisted Krishinda in putting together a bundle of evidence for the tribunal but, she claims, the panel members did not take into account.

She says an NMC panel member pushed for the hearing to go ahead without a lawyer for the midwife.

The panel deliberated for three hours before giving Krishinda an 18-month suspension order.

She said: “They said I was a danger to women.

“I wasn’t given any other information about who to go to, to support me - nothing. That was it, it was over.

“I didn’t feel I was able to work again, particularly not in Scotland. They all know my story. Nobody’s going to hire me.”

Krishinda is not alone in being concerned about the NMC’s procedures.

CATHRYN Watters was struck off three years ago after a fitness to practise hearing. But her sanction was overturned at the high court in London in July 2018 and she returned to work as an oncology nurse.

As a result of her experience she set up the peer support group NMC Watch to aid other nurses and midwives going through the same process.

One of the reasons people leave nursing, Cathryn said, is the adversarial nature of the NMC fitness to practice hearings.

She said: “I was really lucky because I was working as a bank chemotherapy nurse with a private clinic in London, which has known me for years. So when I got back on the register they took me straight back.

“I’ve always said if I hadn’t have got that job I wouldn’t have returned to nursing because I was so shellshocked by it all.”

She is asking the NMC to publish data on what happens to those who go through the hearings process. A snapshot survey of NMC Watch members shows that even among those whose cases did not proceed, one in four never returned to work.

“While there are dangerous people out there who need to be dealt with, we do seem to be removing a lot of people from the profession who, if they were given good mentoring, they would be able to stay. The process is a sledgehammer to crack a nut. “

Cathryn says the NMC has made improvements since her case began, and the culture is changing. But not fast enough, she says.

“It’s very much the allegations are believed immediately and then the registrant has to put their case forward.

“They can’t change until they take away the confrontational system. It’s not open, it’s not honest. And it is very unfair because you’re never going to get back to where you were before.”

Midwife and paediatric nurse Paul Golden is a trained mediator with a background in law who also offered to support to Krishinda.

The NMC, he believes, is failing nurses and midwives.

“The NMC will act like somebody is guilty right from the beginning,” he says.

“Krishinda’s case is not unusual at all, it’s almost a daily occurrence but most people are too devastated to do challenge a decision against them. They can suffer from PTSD, even feel suicidal, and don’t want to return to work.”

Having worked in many countries as a midwife, Paul points to New Zealand as a better model, where a mediator will work with a mother and midwife to resolve any concerns or complaints.

IN England there were around 150 registered independent midwives but in June, due to the pressures of Covid-19 and with Brexit looming, the company providing their insurance withdrew it, leaving them no longer legally allowed to assist with births.

Krishinda is now waiting for her NMC appeal date but says she will not return to practice in Scotland, meaning there are currently no independent midwives working in the country.

Krishinda lodged her appeal at the High Court in London within a mandatory 28 day appeal window.

Glasgow Times: Krishinda Powers-DuffKrishinda Powers-Duff

But the NMC countered that the appeal should have been submitted to the Court of Session in Edinburgh but by this time the 28 days had elapsed and it was too late to reapply to the correct court.

However, the NMC has agreed to an early review of the interim order and this is expected to take place in the new year.

Clare Strickland, Deputy Director of Professional Regulation at the Nursing and Midwifery Council (NMC), said: “Due to the nature of concerns raised, an interim order is imposed while our enquiries continue.

“Our processes allow for an application for a further early review hearing, which Ms Powers-Duff is being supported with.”

Should her appeal be successful, Krishinda is still concerned that her reputation has been permanently damaged, by, she says, standing up for women who want to take a different approach.

“That attitude is not considered acceptable in the mainstream so I was already made out to be this really wacky midwife.

“This black midwife with green dreadlocks who had become private in a place where they don’t even do that. I was just a problem.

“I was supporting these women who refused to comply and there’s nothing worse than a woman who refuses to comply, right?”

She still believes she was right to have intervened when her former patient’s delivery began to go wrong. “If I hadn’t gone, her baby would have died,” Krishinda says.

“I went and I’m glad that I went. And I don’t regret it, but I went and I destroyed my career.”

Krishinda is fundraising to support her legal appeal. See: www.gofundme.com/f/in-support-of-a-midwife