A specialist has defended her decisions about the delivery of a baby who died a week after birth and said managing him otherwise could have caused another life to be lost, an inquest heard.

Freya Murphy died on 28 July 2018 in the Neonatal Intensive Care Unit at the Queen Elizabeth University Hospital in Glasgow, seven days after she was born.

A fatal accident inquest (FAI) at Glasgow Sheriff Court into her death heard that her mother Karen Murphy, 32, a teacher from Cambuslang, South Lanarkshire, was taken on a “red road” on the morning of July 21, after previously being considered. with low risk.

Giving evidence on Wednesday, Dr Marianne Ledingham said every room in the maternity hospital was full and there were “not enough” staff when she arrived for her shift on Saturday morning.

She said Ms Murphy was at the top of her list because of Dr Felicity Watson’s concerns, but there were “competing priorities” because of another woman, Patient A, who also needed to be delivered quickly.

Giving evidence, she said she “intended” to intervene because of the delivery but did not because, on assessment, she believed Freya would be delivered “imminently”.

She said Ms Murphy requested “minimal intervention” and assured the first-time mother she would be back in 10 minutes if Freya hadn’t given birth.

Dr Ledingham said he carried out a vaginal exam at 9.04am and found Freya was in the posterior position, meaning the baby’s head might not have passed through the pelvis, and performed a manual rotation without anesthetic to ” hasten the birth as quickly as possible.”

The specialist said that he had gone to accompany patient A for the theater delivery due to NHS Greater Glasgow and Clyde guidelines and that he was not staffed enough to have two theater deliveries.

She said that the transfer to the inquiry room could take an hour and it may not have meant that Freya was delivered earlier.

Dr Ledingham said that if she had carried out a vaginal delivery at 8.43am it might not have changed the outcome, but “tragically there could have been an adverse outcome for Patient A’s baby as well”.

She told the inquest she thought about the case “every day”.

She disputed earlier evidence from midwife Helen Kidd that concerns were raised about the cardiotocograph and said forceps were not used because Mrs Murphy did not have an epidural, the inquest heard.

“I think it’s very easy to say ‘yes, there was the delivery opportunity at that time’ – the question is: would it have made any difference? I have to be honest, I don’t think it would have made any difference.

“Whenever there is an assessment of adverse outcome, I think there is a tendency to focus on one case. Had I not intervened in Patient A at that time, tragically there could have been a negative outcome in Patient A’s child as well.

“We look at this tragically horrible outcome for Freya and we have to remember that there were other patients that I had to urgently intervene at the same time.”

Under cross-examination, Dr Ledingham said staffing levels were “inadequate for patient safety”. She said consultants were required to go to the hospital for four hours on a weekend on-call shift and could leave if it was not busy.

Dr Ledingham said: “Adequate staffing would have included additional midwives able to open a second theatre, an additional anesthetic consultant, an additional registrar.

“I don’t think there was adequate staffing. I don’t think there was adequate staffing to ensure patient safety.”

She said that during a working day, one of the rooms would have been used for elective caesarean sections, while another team would have been available to open a second room in case of an emergency and there would have been a another working consultant, the inquiry heard.

Dr Ledingham said: “Why should we have different staff from the week? It doesn’t make sense, emergencies happen after hours and on weekends.

“During that shift I was in the building for 12 hours, it was extremely crowded. I was in theater several times during the day, I’m doing emergency caesareans, I remember not eating or going to the toilet, it was completely hectic.”

The investigation continues before Sheriff Barry Divers.