Jehovah's Witness who refused blood transfusion after giving birth died 'faithful to her God', inquest hears

London, UK - The mother of a Jehovah's Witness who refused a blood transfusion after giving birth told a doctor she died 'faithful to her God', an inquest heard yesterday.

Emma Gough, 22, lost more than four pints of blood after developing a 'huge' clot shortly after delivering healthy twins.

An inquest heard yesterday how she was left sedated and on a ventilator before she died hours later of severe anaemia, after five attempts by doctors to persuade the family to allow a blood transfusion.

Mrs Gough had signed an 'advanced directive' during her pregnancy expressly banning a blood transfusion because of her faith.

Yesterday her widower, Anthony, 24, and her family looked on as a succession of medics involved in her care told how a transfusion would have saved her life.

Olufunso Oyesanya, the consultant gynaecologist on duty when Mrs Gough was admitted to the Royal Shrewsbury Hospital last October said leaking blood vessels caused Mrs Gough to lose 'at least' two litres of blood - more than four pints. Such a collection of blood is known as a haematoma, or blood clot.

He said the patient knew about the risk of haemorrhaging after giving birth and had had a 'long discussion' with colleagues at the hospital earlier in her pregnancy in view of her religion, which dictates that certain bible passages explicitly prevent them from receiving transfusions.

Her position remained unchanged at the hospital, he said.

The Shrewsbury inquest heard that, after an operation to try and stem the blood flow, Mrs Gough was taken under sedation to the intensive care unit (ITU).

Mr Oyesanya spoke to her mother, Glenda Delaney, and the patient's husband, Anthony, 24, a central heating engineer, who 'fully understood' that her 'critical' situation could be rescued by a blood transfusion.

He and a 'team' of medics and midwives went back to the family to again plead for them to reconsider a transfusion, before a third approach later that night.

But the family, by now supported by a church leader, still would not consider a transfusion. After assessing Mrs Gough in ITU he then wrote on her notes: 'NEEDS BLOOD TRANSFUSION. FAMILY STILL REFUSING BLOOD.'

The family were approached a final time and their church leader told Mr Oyesanya they would not consider the matter.

"Somebody told me it was a conscience matter", the doctor told the hearing. The medic said he 'fully respected' the family's decision.

Mrs Gough died in the early hours of the following morning. Mr Oyesanya told the hearing how he had spoken to Mrs Delaney later that day, who told him: 'At least she remained faithful to her God'.

The inquest heard Mrs Gough, of Telford, Shropshire, had been admitted to hospital more than two weeks before her due date suffering from suspected ruptured membranes - usually a signpost that labour is imminent.

The twin boy and girl had a ventouse delivery - where a suction cup is placed on the baby's head and a pump is then used to help pull the baby out - but arrived healthy. Staff were forced to cut Mrs Gough to aid their birth, a routine procedure known as an episiotomy.

In Mrs Gough's case, the episiotomy caused internal bleeding requiring further surgery, and ultimately, a blood transfusion.

Professor Archibald Malcolm, who performed the autopsy on Mrs Gough, told the hearing her refusal to sanction a blood transfusion resulted in acute anaemia - where the body has insufficient red blood cells to carry oxygen, which is needed for organ function.

He said the cause of death was 'profound anaemia' as a result of haemorrhaging due to complications in giving birth.

The inquest heard the haematoma may have been the result of the episiotomy cut going deeper than anticipated. Nicholas Reed, a consultant in obstetrics and gynaecology at the hospital, who was not on duty at the time, said this could have meant that any internal bleeding was not initially noticed when the tear was first repaired.

Mr Reed said vaginal haematoma was a well-known complication in childbirth which affected one in 2000 women. All three experts told the hearing they believed a blood transfusion would have saved Mrs Gough.

Mr Reed told the coroner: "I think that if we had transfused at an early time, then a young, fit lady like Mrs Gough would have survived and I think all obstetrics staff would agree with that."

The inquest continues.