A young mother of two died from blood clots in her lungs just weeks after giving birth by Caesarean section.
Jasmine Donkin, 20, developed deep vein thrombosis three weeks after giving birth to a baby girl.
The condition is the leading direct cause of maternal death in Britain. The NHS says the risk of developing it is greater for those having a caesarean section.
Medics deemed Jasmine was at a low risk of the condition so they opted not give her an extended dose of blood-thinning drugs after the caesarean.
But Jasmine, of Herne Bay, Kent, collapsed at home and died just 22 days after giving birth to her daughter Callie-Grace.
A post-mortem examination revealed blood clots had formed in her lungs, which starved her brain of oxygen stopping her heart twice.
Jasmine’s heartbroken mum, Kim Connolly, described her daughter as “amazing” and “out of this world.”
She said: “She was a brilliant mother. They couldn’t have asked for a better mum.”
The grandmother added: “Callie-Grace is doing really well. Storm is clearly missing mummy. When she is old enough she will understand that mum was truly the best. No one had a bad word to say about her.
“If I would swap places with her if I could. Now my grandkids have no mum to grow up with. Twenty is nothing.”
Mrs Connolly is now calling for all women undergoing caesarean sections to be prescribed the blood-thinning drug Clexane – and not just those at high risk.
She said: “I want to make it clear to people that it’s a problem that has to be solved and I will fight it until we get some answers.
“I think if Jasmine had the blood-thinning drugs she might still be here.
“She was perfectly healthy. They said there was no risk, yet she died of blood clots, so there had to be some sort of risk.”
Mrs Connolly, herself a mum-of-eight, added: “Having the drugs could save someone’s life.
“And I think not having them is just to save money. I would quite happily pay for them to save my daughter’s life.”
An inquest into Jasmine’s death took place at County Hall in Maidstone, Kent, on Monday.
The hearing was told how Jasmine’s first child, a boy called Storm, was delivered by caesarean in 2018 following three miscarriages.
When she found out she was pregnant a second time, Jasmine opted for a planned caesarean and on December 9 last year gave birth to a healthy girl at the William Harvey Hospital in Kent.
The mum-of-two raised concerns about her surgery wound two weeks later, on December 23, but no signs of infection or thrombosis were found.
During a second review four days later, the wound was “red and hot” and Jasmine was prescribed antibiotics, as a small area appeared to be infected.
On New Year’s Eve, the young mum complained of a tight chest and trouble breathing, so her partner, Matt Cullen, from Whitstable, Kent, called an ambulance.
But shortly after paramedics arrived at their flat at about 2.45pm, she collapsed with dilated pupils and went into cardiac arrest.
Paramedics gave CPR for three hours, with an air ambulance doctor and off-duty anaesthetist helping at the scene.
She was rushed to the QEQM Hospital in Margate, Kent, where doctors worked hard to stabilise her.
But scans revealed blood clots in Jasmine’s lungs, which had starved her brain of oxygen.
She suffered a further cardiac arrest and died at 10.27pm the same day.
But two investigations – one by the QEQM and another by the independent Healthcare Safety Investigation Branch – concluded risk assessments of Jasmine had been properly carried out in “accordance with protocols.”
Jasmine did not meet the risk factors required to be prescribed an extended dose of Clexane, or any other blood-thinning medication.
The QEQM’s deputy head of midwifery, Hannah Horne, did raise other issues as part of the investigation.
She said: “My only concern was what was documented on the electronic discharge notification.”
“[It stated] Clexane had been prescribed, but actually it wasn’t, and that was a mistake [for it to be on the notification].”
She also said there was a “lack of clarity over the roles and responsibilities of discharge staff” at William Harvey, but these concerns had “no influence on the mother’s outcome”.
Assistant coroner Scott Matthewson said Jasmine died of “natural causes” after developing deep vein thrombosis following a caesarean section. It led to blood clots in her lungs, which caused brain damage and cardiac arrest.
He added: “The conclusion was that death could not have been avoided and I’m sure that will come as cold comfort to Jasmine’s family and partner.”
A spokesperson for East Kent Hospitals said: “We offer our deepest condolences to Jasmine’s family.
“We welcome the coroner’s thorough inquiry into Jasmine’s death, which concluded that she died of natural causes as a result of developing a rare type of blood clot and that her death was unavoidable.
“Jasmine had none of the usual risk factors associated with developing blood clots. The coroner noted that Jasmine was correctly assessed as low risk for developing them.
“The coroner noted that the Trust’s thorough investigation found that doctors appropriately followed the relevant Royal College of Obstetricians and Gynaecologists guidelines by not prescribing an extended course of blood-thinning medication following a caesarean section.”