There were "no red flags" to suggest that anything was wrong in the hours before a baby girl died after her head became trapped during labour, an inquiry has been told.

A fatal accident inquiry at Glasgow Sheriff Court has heard that Mirabelle Bosch suffered a catastrophic brain injury as as result of oxygen deprivation during a breech delivery - where babies are born feet or bottom-first instead of head-first.

After her waters broke on June 30 2021, Mirabelle's mother, Rozelle Bosch, had attended the maternity triage unit at Wishaw General hospital with husband Eckhardt, but was given the all-clear and sent home with an appointment to return at 9am on July 2 to be induced or earlier if her contractions indicated that she was in active labour.

READ MORE: 

Paramedics were subsequently called to the South African couple's home in Shotts on July 1 but were unable to fully deliver Mirabelle and sought specialist help from medics. However, they were only able to speak to hospital doctors over the phone.

A second ambulance crew attended and tried to make contact with maternity triage at Wishaw General, but it took five attempts before their calls were answered.

Mrs Bosch was eventually transferred to hospital by ambulance but Mirabelle was described as "white, floppy" and with "no audible heart rate" when she was born.

She was just 12 hours and one minute old when life support was withdrawn on July 2, 2021.

All parties participating in the inquiry have agreed that Mirabelle's head was trapped throughout delivery.

A post-mortem examination, conducted by Dr Dawn Penman, found that Mirabelle was "well" prior to the birth and that delays in transferring Mrs Bosch - a first-time mother - to hospital had contributed to her daughter's death.

In a report, Dr Penman also questioned why a 31-week ultrasound scan - which indicated that Mirabelle was in the breech position - had not influenced decision-making by healthcare staff at the time of Mirabelle's birth seven weeks later.

The inquiry has also heard that an antenatal appointment at 37 weeks had identified that Mirabelle's head was "not engaged" - fixed in the pelvis - increasing the risk of umbilical cord prolapse, a potentially life-threatening complication.

Michelle Tannahill, the midwife who carried out a physical examination of Mrs Bosch's abdomen when she attended Wishaw General on June 30, said that she had "no doubt" that Mirabelle was engaged by that point and back in a cephalic - head-first - position, in line with the findings of prior antenatal midwife check-ups at weeks 34 and 37.

There was no sign of infection and no worries about foetal movement or growth, added Ms Tannahill.

She said: "There were no red flags...there wasn't anything that was alarming."

The Herald: The inquiry is probing the deaths of three infants where the circumstances are said to have given rise to 'serious public concern'The inquiry is probing the deaths of three infants where the circumstances are said to have given rise to 'serious public concern' (Image: PA)

Ms Tannahill told the inquiry that it was "possible" if she had carried out a vaginal, rather than abdominal, examination that she may have discovered that Mirabelle was in breech but there was no clinical reason to do so unless contractions had begun and that it would also risk causing an infection.

"I had determined what I was feeling was bony rather than soft buttocks," said Ms Tannahill, confirming that meant the infant's skull had been fixed in Mrs Bosch's pelvis ready for birth.

She added that the only way to be "100% sure" of a baby's position at the beginning of labour would be to scan the mother, but there had been no reason to do so in Mrs Bosch's case.

There was no reason to take the 31-week scan into account, said Ms Tannahill, because "a baby changes position all the time". 

"The position of a baby under 36 weeks - there's no concern about that," said Ms Tannahill.

The FAI is investigating the deaths of three infants, including Mirabelle, who all passed away in circumstances that the Crown Office has said give rise "to serious public concern".

Later stages will probe the case of Ellie McCormick, who died five hours after her birth at Wishaw General on March 5 2019, and Leo Lamont, who was two hours old when he died at Monklands hospital in Coatbridge on February 15 2019.

NHS Lanarkshire, NHS Greater Glasgow and Clyde, and the Scottish Ambulance Service are among the participants.

The inquiry, chaired by Sheriff Principal Aisha Anwar, is expected to conclude on March 1.