April: Spotlight on an expert

Introducing Midwifery expert witness Gemma McIntyre...

I decided to train as a midwife following the birth of my daughter in 2008. It was a traumatic birth with a keillands forceps delivery and a stint in the neonatal unit for my daughter, but the support and care I received from my midwife made all the difference. I knew then that I needed to become a midwife. I started my training at the University of Hull in 2009 when my daughter was 11 months old. It was tough leaving her, especially as I was still breastfeeding, but I still remember walking onto the labour ward for the very first time and knowing that this was where I belonged.

I qualified as a midwife in October 2012 and was able to secure a job at my local Trust. I delayed my start date until August 2013, as I finished the course heavily pregnant with my son. He was born at home in a birthing pool and I count him as my very first ‘catch’ as a qualified midwife!
Once I returned to work I moved around different rotations, gaining experience in all aspects of midwifery care. The unit where I worked had a labour, delivery, recovery and postnatal (LDRP) set up, so I would care for mothers in the antenatal period, during labour and postnatally all on the same ward. I loved the continuity this gave me, especially after spending 6 months in a community setting where I cared for the same caseload of mothers. I loved being part of the team and felt my confidence and competence grow.

In 2015 I decided I would complete a Master of Science in Health Studies, which allowed me to choose modules that were relevant and interested me. As part of this I completed a module in advanced clinical practice, examination of the newborn and mentorship and completed a dissertation
looking at the role of debrief for midwives following traumatic incidents. In 2017 a new post was created in my Trust and I become a specialist midwife. My role consisted of all aspects of governance including completing serious incident investigation reports, guideline development, audit and running and teaching on the education programme. It was a huge task and wasn’t always well received by my colleagues, however by the time I left in 2019 I felt I had really started to make a difference. I also completed training to become a Professional Midwifery Advocate and used my skills from this to support newly qualified midwives during their preceptorship period.

In early 2019 I saw an advert for a role as a maternity investigator working for what was then the Healthcare Safety Investigation Branch or HSIB. For those not from a midwifery background the maternity element of HSIB was set up in 2018 to perform independent investigations into maternity incidents. These include term (after 37 weeks of pregnancy), intrapartum stillbirths (when a baby dies during labour), early neonatal deaths (within the first 6 days of life), cases where a baby has a brain injury and maternal deaths (when a woman dies during or within the 6 weeks following a pregnancy). The focus is looking at systems and processes and not apportioning blame or liability but focusing on learning. We work closely with families and also speak with clinicians to gain a full understanding of what happened and why decisions made sense at the time.
The job appealed to me as I felt I would be able to make a difference on a national scale without many of the constraints I faced within a small Trust.

In July 2019 I started the intensive three week training course which included sessions on human factors and ergonomics. I soon settled into the new role and found I really enjoyed investigating incidents, interviewing clinicians and writing reports. I felt that I had found a way to make a difference to families and babies. I’ve been with the organisation for almost 5 years now and have seen many changes, including our most recent change of name to Maternity and Newborn Safety Investigations or MNSI. It has been tough at times, working with families who should be celebrating one of the most exciting life events, but I hope that we continue to contribute towards saving the lives of mothers and babies.

Following completion of my MSc in 2017 I was bitten by the academia bug and in 2018 started a part time PhD. I am now in my final year woohoo! My research is looking at the lived experience of parents involved in HSIB/MNSI investigations using an interpretive phenomenological methodology (IPA). I am very lucky that 9 wonderful families have shared their experience with me and I am currently deep in the process of analysing the data.

In 2020 we decided to move from Lincolnshire to the North East. It was a huge undertaking, especially given it was the middle of the Covid pandemic. You may have realised by now that I like a challenge though! I started working for my local trust in Durham as a bank midwife and that in itself has been an interesting learning curve. Trying to navigate the computer system, the guidelines and the names of everyone has been really tough. The worst thing is standing in the store cupboard looking for something and not knowing if it’s because it’s not stored in there or just because you can’t see it! The midwives at Durham have been incredibly patient and welcoming and I’m relieved to say that babies come out the same way whether you’re in Lincolnshire or Durham!

I had been interested in expert witness work for quite a while and decided to put in an application to Somek and Associates. And here we are! After completing the training I was excited to get started and luckily enough I received instructions on my first case in the September. I found my experience of report writing for MNSI both a help and a hinderance. Luckily my wonderful trainer, Julia, was on hand to guide me through. The main difference is that with MNSI we don’t look at individual actions and as an expert witness we very much do! Working for MNSI has given me some great transferable skills though. I have attended inquests and been called as a witness, including being cross examined. I also feel my report writing skills have helped me. Ultimately the part that has been most helpful to me is the independence — with MNSI we do not work for a Trust or for a Family, just as when working as an expert witness we may be instructed by Claimant or Defendant but our overall responsibility is to the court.
I have now been instructed on ten cases and feel my report writing is improving with each case. I work Monday to Thursday for MNSI and Fridays are my expert witness or PhD days, although I’ve been known to ‘just take a quick look’ at a case and look up five hours later wondering where the time has gone! I love how Somek works, I know I will only be sending out reports that are professional and I have found the training package has been excellent. I can’t wait to see where my career with Somek takes me next!

If Gemma's journey so far has sparked your intrigue, why not take a look at our recruitment pages for more information about how you can enhance your clinical practice through expert witness work.