Pregnant woman's blood clot death 'unbearable'

The family of a pregnant woman who died along with her unborn child from a pulmonary embolism believe they should both still be here.

Charlene Wakley, 24, from Honiton, Devon, was treated at the Royal Devon and Exeter Hospital three times for extreme pregnancy sickness - diagnosed as hyperemesis gravidarum (HG).

Charlene died five days after her third admission to hospital and the NHS trust later admitted her care was "not up to standard".

The Royal Devon University Healthcare NHS Foundation Trust told the BBC it had taken "action to address the issues identified and to strengthen the quality of our services".

"No father should have to do this," said Charlene's father Adrian Wakley, who has sat by his daughter's grave every night since she was buried.

"He's never missed a day by her graveside - not once in five years," Charlene's older sister Margaret Wakley said.

Charlene was living with her boyfriend and working as a dispenser in a pharmacy in Exeter when she discovered she was pregnant.

She had long wanted a family and her sister said was delighted to find out in early 2021 she was expecting a baby.

"She was really pleased. She'd watched me and my other sister have our children, and she loved them so much that she wanted to have her own," Margaret said.

"It was what she'd always wanted, wasn't it?" Adrian added.

Charlene's pregnancy was not easy. She quickly became unwell, vomiting throughout the day and becoming increasingly immobile and dehydrated.

She was diagnosed with hyperemesis gravidarum - described by the NHS as prolonged and severe nausea and vomiting in pregnancy.

"She was really unwell," Margaret said. "She couldn't keep anything down. She was weak and could barely move at times."

At just over nine weeks pregnant in late February 2021, Charlene became extremely ill.

Margaret said: "She was at home and she had just been sick. She went upstairs and her partner heard a crash... he heard her say: 'I can't breathe.'"

Charlene was taken by ambulance to the Royal Devon and Exeter Hospital but medics were unable to resuscitate her.

A post-mortem concluded Charlene had died from a pulmonary embolism - a blood clot that had moved from her leg, via her heart, to her lungs.

The NHS describes a pulmonary embolism as "when a blood clot blocks a blood vessel in your lungs".

A research project led by the University of Oxford called MBRRACE-UK has found blood clots are the leading cause of maternal deaths in the UK for women up to six weeks postpartum.

Its research suggested there was a 50% in the UK's maternal death rate from 2013 to 2023.

Dr Allison Felker from the project confirmed maternal deaths rose from 8.54 deaths per 100,000 pregnancies in 2013, to 12.80 in 2023.

Kim Thomas, from the Birth Trauma Association, a group campaigning for better maternity care, said: "The figures are very worrying and, in fact, direct maternal deaths have increased by 50% since that period [2023], so that's a very high increase.

"That's deaths from conditions that are caused directly by pregnancy or birth - such as the pulmonary embolism Charlene developed."

Thomas added she believed Charlene should "certainly have been monitored due to her severe pregnancy sickness".

Following her death, Charlene's case was referred to what was then called the HSIB - the Healthcare Safety Investigation Branch, now known as the Health Services Safety Investigations Body.

In its report, it highlighted that the impact of extreme pregnancy sickness on Charlene was not fully understood by the hospital.

It also found there was no acknowledgement of thromboembolic risks , which is the likelihood of developing a harmful blood clot.

The Royal Devon and Exeter Hospital apologised to the family for Charlene's care, and said it "was not always of the appropriate standard".

Carolyn Mills, chief nursing officer at the hospital, said: "I would like to express my sincere condolences to Charlene Wakley's family for their loss. I recognise how difficult this experience has been for them.

"The Royal Devon carefully reviewed the findings and recommendations of the HSSIB investigation, taking actions to address the issues identified and to strengthen the safety and quality of our services."

Mills added: "The trust is committed to learning from every case to improve the care we provide for our patients.

"Our focus is always on providing the best possible care and experience for all of our patients."

The Royal College of Midwives said "the risk of developing VTE [blood clots] is assessed at a pregnant woman's first appointment with a midwife".

"Risk assessment is ongoing throughout pregnancy and should take place routinely during key phases in the maternity care journey," it added.

Women with hyperemesis gravidarum such as Charlene are also at an increased risk of blood clots, according to the NHS.

Charlene's sister and dad said they believed she was not properly warned.

"If she'd had better care, I believe the embolism would have been picked up," Margaret said.

"She would still be here," Adrian said. "The level of heartbreak is... just unbearable".

Margaret added: "Please, if someone comes to you and says that they're worried, please just check, because it might just save their life and their baby."

If you've been affected by any of the issues raised, please visit BBC Action Line to find information on organisations that can help.

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