Poppy Hope Lomas died seven days after birth due to complications from an unsafe home birth encouraged by midwives at Barnet Hospital, an inquest has found. The senior coroner Andrew Walker ruled that the Royal Free London NHS foundation trust failed to warn the mother, Gemma Lomas, of the risks and supported a delivery that was against medical advice.
Inquest findings
The inquest concluded that Poppy likely died from a lack of oxygen reaching her brain in the 30 minutes before birth. Walker stated that the trust agreed to support an unsafe home delivery and did not address an accumulation of risk factors. Gemma Lomas said she trusted the professionals guiding her and hoped lessons would be learned.
Background
Lomas had previously given birth by caesarean section in 2018. Despite guidelines recommending vaginal births after caesarean (VBAC) should occur in a suitably staffed delivery suite, midwives encouraged a home birth. The Royal College of Obstetricians and Gynaecologists advises that VBACs should have resources for immediate caesarean delivery.
In England and Wales, about one in 50 births take place at home, but only for low-risk pregnancies. Experts have called for clearer warnings on the dangers of home births after similar cases.
Coroner's recommendations
The coroner flagged concerns about the phrase 'out of guidance' being used instead of 'against medical advice'. He recommended multi-disciplinary meetings with parents when an unsafe home birth is chosen and that consent forms clearly explain risks.
A trust spokesperson offered condolences and said measures have been introduced to improve care, including better communication and ensuring midwives know guidance on hospital transfers. The trust will respond to the coroner's issues in due course.
