It was some time just before 5am on the morning of June 3 last year when Jennifer Cahill began to realise her dream of a peaceful and natural home birth for her second child was going badly wrong.
By then the 34-year-old, who’d been scarred by a traumatic hospital delivery of her son three years earlier, was tired after almost eight hours of labour, yet her daughter was still no closer to being born.
‘I really want to do this, I am a warrior,’ Jennifer shouted in desperation. ‘Why will my body not let me?’ Although baby Agnes was finally delivered around 6.50am, by then it was too late – the damage had been done.
By the next day, Jennifer was dead, having suffered a repeat of the severe haemorrhaging she’d experienced with her son the first time around.
Unlike in 2021, however, doctors were unable to save her this time. She suffered a cardiac arrest in the ambulance and died of multiple organ failure at North Manchester General Hospital.
Sadly, only a few days later at the same hospital, Jennifer’s devastated husband, Rob, had to say goodbye to his three-day-old daughter as well.
Agnes – who was born not breathing, with the umbilical cord wrapped around her neck – was kept alive on a ventilator so he and other relatives could spend some time with her before she, too, passed away.
In evidence given to an inquest in Rochdale, Greater Manchester, this week, Rob said: ‘[Agnes] was able to meet my family. I held her and told her stories about her mother, who never got to hold her or say goodbye. Nothing can be done now to reverse these awful facts.’
Jennifer Cahill (right, pictured with her husband Rob) died after suffering severe haemorrhaging when giving birth to her second child, who tragically died a few days later
That inquest is ongoing, but already shocking details have emerged about the apparent failure of the NHS to spell out the potential fatal dangers of a home birth to Jennifer, who was deemed high-risk because of the previous haemorrhage, or the unwillingness of medics and midwives to question and challenge her strict birth plan, which stipulated no drugs and no intimate examinations.
Rob Cahill told the court that his wife had been left traumatised by the ‘highly stressful’ forceps birth of their son and was determined to avoid a repeat of the complications she suffered afterwards. (She had needed two blood transfusions and spent seven days in hospital with the newborn. Her son contracted Group B strep after she tested positive for the bacteria in labour, and subsequently developed sepsis.)
Consequently, when Jennifer, an international export manager, became pregnant with the couple’s second child, she was steadfast in her belief that having her daughter at home would be the best option.
She joined a home birth group on Facebook, and one comment posted in December 2023, when she was already 16 weeks pregnant, perhaps explains why she was so fearful of returning to hospital.
In response to another mother who was blaming herself for her baby developing an infection, Jennifer wrote: ‘I’ve been through this and it was the toughest week of my life in hospital with a poorly baby and the nights on your own are so lonely, I wouldn’t wish it on anyone.’
Earlier this week it emerged at the inquest that police have investigated the Facebook group, Home Birth Support Group UK, which is run by private doula and self-professed birthing activist Samantha Gadsden, but decided to take no action.
The group, which had 14,000 members but was taken offline this week, boasted: ‘We are not your average group…we question the medical norms…please respect this.’
As well as birthing tips, it offered discounts on birthing pools and also encouraged pregnant women to donate via Ms Gadsden’s personal website. Midwives are charged £50 to join and mums-to-be can also pay up to £60 for personalised advice.
However, comments posted on social media and seen this week by the Daily Mail before the site, and Ms Gadsden’s Instagram account, was locked down, reveal an aggressive anti-hospital, pro-home birth agenda. Just last month Ms Gadsden posted: ‘You do not need permission from a midwife to birth in your own home.’
While in older posts she professed: ‘Hospital birth is not safe. Home birth is not dangerous’. She added: ‘Sending hospital birth-traumatised women back to hospital is like going back to a restaurant after food poisoning for a second dose.’
Ms Gadsden, who has described NHS maternity services as ‘broken,’ slammed the door and refused to comment when contacted by the Daily Mail at her home in a village close to Caerphilly, south Wales, yesterday.
One midwife who specialises in home births and who joined Ms Gadsden’s Facebook page told the Daily Mail she believed Ms Gadsden had kicked her off the forum because she’d pulled Ms Gadsden up for spreading misinformation.
Jennifer (above) suffered a cardiac arrest in the ambulance and died of multiple organ failure at North Manchester General Hospital after the home birth of her daughter Agnes
The midwife described her as ‘self‑righteous’ and more bothered with ‘appearing knowledgeable’ than actually giving women balanced information.
‘I was looking into these groups about home births and had seen she was advising someone about high blood pressure,’ the midwife told the Daily Mail. ‘I thought I would offer my advice, too, as I had high blood pressure for my first two pregnancies.
‘It was about a woman having to go into a medical assessment unit [in hospital] and she [Ms Gadsden] was telling them they didn’t need to.
‘I said what I thought about the matter and she gave me a right mouthful back, saying it was her site and I cannot comment on it.’
How much Jennifer was influenced by the group or chatter online may never be known, but Dr Azel el Adwan, an obstetric trainee, who discussed the risks of a home birth with Jennifer during a clinic visit, said she had seen a rise in requests for home births from expectant mothers ‘affected’ by social media.
The medic admitted it wasn’t common practice to use the word ‘death’ when talking to pregnant women about the risks of home births because fatalities were so rare. She insisted ‘we cannot persuade a patient…to do something they don’t want to do’.
But what is clear is that by 9pm on June 2, when Jennifer went into labour, she had opted to go against medical advice and had devised what Julie Turner, one of the two attending community midwives, described as the ‘most intense’ home birthing plans she had ever seen.
Ms Turner, and her colleague, Andrea Walmsley, had already worked a 12-hour shift that day, but were on call and arrived at the Cahills’ home, in Prestwich, Greater Manchester, at around 11.20pm.
They told the inquest that they were shocked to find the birthing room lit by just a few tealights. Jennifer explained her plan to the midwives, insisting she wanted no drugs (including the medicine syntometrine, which is administered to prevent excessive bleeding), no observations and no intimate examinations. She also told them she wanted to keep the environment as calm as possible, so they should keep their voices to a whisper when talking to her.
At first, everything seemed to be going well, with Jennifer requesting just gas and air to help her through the pain. However, by around 2.30am the midwives realised the canister delivering the gas and air was faulty and Jennifer was in distress. Ms Turner left to get a new canister. When she returned 50 minutes later, Jennifer responded immediately to the new gas and air, which helped reduce her discomfort.
But she continued to refuse the midwives’ requests to give her a strep B test or a vaginal examination, even turning her back when Ms Walmsley asked for a urine sample. ‘I thought I had overstepped the mark,’ the midwife said. ‘I felt that I would be thrown out if I said the wrong thing.’
By 4am, however, it was clear the labour was going off-track. Jennifer’s blood pressure was recorded as being slightly raised, and she finally agreed to be examined so the baby’s heart rate could be monitored. At this stage, it was still strong, so when Jennifer’s waters broke, at around 4.45am, she was advised to push.
After being left traumatised by the ‘highly stressful’ forceps birth of her first child, which came with an array of medical complications, when Jennifer fell pregnant with the couple’s second child she was steadfast in her belief that having her daughter at home would be the best option
But problems continued and, although Agnes’s head was visible around half an hour later, it ‘kept retracting’ – most likely, the inquest heard, because the umbilical cord was wrapped around her neck. Ms Walmsley said: ‘Jen was not pushing properly. She was pushing with her face instead of with her bottom. We were talking in whispers because the birth plan asked us to keep interference to a minimum.’
It was around this time that Jennifer started ‘beating herself up’ about not being able to deliver her baby. Ms Turner said: ‘She was struggling and shouted: ‘I really want to do this. I am a warrior. Why will my body not let me?’ ‘
Records also show that, between 5.45am and 6.24am, Agnes’s heart rate was steadily falling. The baby girl was eventually born at 6.49am but she was not breathing and was covered in meconium – the first, sticky stool of newborns – which can cause serious breathing difficulties if accidentally inhaled.
Ms Turner started to try to resuscitate Agnes, but the mask in the sterile emergency resuscitation kit the midwives had didn’t fit. Ms Walmsley said her colleague was ‘absolutely covered’ in the meconium as she tried to give Agnes mouth to mouth. ‘I was in a blind panic,’ she admitted. ‘It was absolute chaos. We were both in complete shock.’
At the same time, Mr Cahill dialled 999. When the first ambulance arrived just four minutes later, senior paramedic Sean Scroop immediately took control, ordering the curtains to be opened and the lights turned on.
By the time the ambulance left with the baby at 7.09am, however, Jennifer was also in trouble. Minutes later, she began to bleed heavily after delivering the placenta. She, too, was taken to hospital but lost almost half the amount of blood in her body and went into cardiac arrest in the ambulance. Jennifer died of multi-organ failure the following day.
Paramedic Adrian George said ideally they would have done more observations before transporting Jennifer but added: ‘She wanted us to leave her alone. I was comfortable with respecting her wishes.’
The inquest was told Greater Manchester Police officers had spoken to Ms Gadsden, who said she didn’t ‘recall any previous conversations with Jen’. The coroner also noted that, in the Facebook group’s description, it stated that no medical advice was given.
Both midwives admitted to the inquest that prior to Jennifer’s death there had been growing ‘unease’ at work about a ‘significant increase’ in call-outs to high-risk home births. ‘We seemed to be getting more women with complex plans,’ Ms Turner said. ‘Staff were fearful. It is one of the reasons we now go out in twos so that we can support each other.’
The midwives, who repeatedly broke down in tears at the inquest, admitted to keeping poor records and failing to follow NHS guidelines on monitoring Jennifer’s blood pressure and Agnes’s heart rate, or comply with national standards for resuscitation.
Ms Walmsley insisted she noted down the baby’s heart rate on an incontinence pad, which was subsequently thrown away, while Ms Turner said she scribbled other readings down on a piece of paper that has since been lost.
Ms Walmsley explained it had been difficult to make notes in the dark room and that others were only made the following day after both of them had been up for more than 24 hours.
Asked by coroner Joanne Kearsley whether midwives ought not to be attending high-risk home births straight after finishing a long shift, Ms Walmsley said this was typical of working in an over-stretched NHS.
‘It doesn’t happen in community midwifery,’ she replied. ‘There is no back-up, there is no help. If you dare to stick your head up you just get shot at.’ Both midwives have not returned to work since Jennifer’s death.
Although the inquest will come to a close next week, for Rob Cahill, their little boy and the rest of Jennifer’s loved ones, the agony will never end.
- Additional reporting: John Kelly
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