Prisoner's baby died one day after birth - inquest

A prisoner's premature baby died in hospital a day after he was born by emergency Caesarean section, an inquest has heard.

Orion Homer was born at 01:06 on 15 October 2023 at Royal Derby Hospital at 34 weeks plus five days gestation and died the following day.

An inquest at Derby Coroner's Court heard his mother Ellen Roberts was a prisoner at HMP Foston Hall and was taken to the hospital on 14 October after she raised concerns about reduced foetal movement.

Orion was "gravely unwell and very pale" when he was born and needed CPR and breathing support, the inquest heard.

Roberts had spent some of her pregnancy in prison in June and July 2023, before she was released at the end of July but recalled back on 10 October, the jury inquest heard.

Dr Bemigho Etuwewe, a consultant in the neonatal team at Royal Derby, was on call at the time of Orion's birth.

Etuwewe said in evidence that Orion was "gravely unwell and very pale" when he was born and was not breathing by himself.

He also had lots of fluid around his body below the skin, and was not moving much, Etuwewe told the court, so the neonatal team was called in and Etuwewe arrived at 01:29.

He said Orion's heart was struggling and he was anaemic, said Etuwewe.

When asked when the neonatal team became aware of this case, he said: "I do not think the neonatal team knew until 01:06 [when Orion was born] that we had a rhesus patient on labour ward.

"In hindsight, we should have been informed we had a high-risk pregnancy in the hospital. I don't know why we did not know."

When asked if they should have known, he said: "Yes, that is practice - we should have been told about a high-risk pregnancy.

"I believe if we would have known, I would have been present (at the birth), not saying the care provided would have been any different but I would have been there to support the team."

Orion was treated at the hospital until the next day where it was decided nothing more could be done to save him.

Jessica Smith, who works for Birth Companions, which supports pregnant women in prison, also gave evidence on Monday.

She said Roberts told her she had "raised" her reduced foetal movement with the prison on 12 and 13 October, but was not taken to hospital until 14 October.

The coroner asked if she shared with Smith who she had told about the reduced movement, but Smith said Roberts did not.

Smith said: "She was telling me she raised the issue within the prison but I can't be sure who she spoke to."

The court heard a post-mortem report listed the cause of Orion's death as meconium aspiration, foetal distress, and hydrops fetalis from rhesus incompatibility, a condition where the mother and baby have different rhesus blood types.

This means Roberts had antibodies that attacked her baby's red blood cells.

Premature birth was also listed as a contributing factor.

The post-mortem report also said Roberts was in the methadone programme, and had used crack cocaine and heroin during the week of Orion's death.

The jury heard Roberts, who was not at the inquest, had two previous pregnancies where she and her babies had different rhesus blood types, and one baby required a post-birth transfusion and another had an intrauterine transfusion.

The inquest continues.

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