During a difficult Caesarean section birth where a mother's lips turned blue and she kicked out in pain, a doctor is said to have shrugged his shoulders, looked disinterested and said he had "real surgery" to get to.
This lack of concern left a midwife present at the birth "incredulous".
The doctor, who has name suppression, was working as an anesthetist in Auckland in February 2013 when the mother had her baby delivered through surgery to her uterus and abdomen.
The pain relief the doctor administered to the mother, whose name is also suppressed, was said to be inadequate and the doctor is today before the Health Practitioners Disciplinary Tribunal in Wellington facing a charge of professional misconduct.
Prosecutor Nicola Wills said the doctor did not give the mother enough pain relief, did not check the adequacy of the dose properly and didn't react to signs it wasn't working.
The mother told the doctor during the operation she was feeling pain, yet the doctor did nothing about it, Ms Wills said.
At one point the mother had to be asked by the surgeon working with the doctor to stop kicking her legs.
Ms Wills said the surgeon was concerned about the level of pain the mother was in.
After the baby was delivered and the procedure continued, the doctor did not give the mother any extra pain relief.
"[The doctor's] attitude during the operation is at issue. The prosecution case is that he decided [the mother] could cope with the pain, the operation would be over soon and he was then disinterested and did not respond adequately to [the mother's] expressions of pain, both verbal and non-verbal, and concerns raised by others," Ms Wills said.
The mother's partner had said she told him at one point: "I'm feeling it".
But he assumed everything was on track as the doctor appeared unconcerned and had reassured the mother she wasn't feeling pain, just "pressure".
Midwife Rosie Johnson said the doctor appeared "disinterested" at the mother's "obvious discomfort".
As the incision was closed, Ms Johnson noticed the mother's blood pressure had dropped and her lips had turned blue.
Ms Johnson asked the doctor for more pain relief. He checked the blood pressure, decided it was fine, shrugged his shoulders and said "it will be over soon", Ms Wills said.
"Rosie Johnson's evidence is that she was incredulous at [the doctor's] lack of response."
The mother, her partner and a student midwife all heard the doctor say either he had a "real surgery" or "real operation now" after the Caesarean.
The matter has previously been heard by the Health and Disability Commissioner, which in a decision issued last year said the doctor's failure to administer adequate levels of anaesthesia was "suboptimal".
"[The doctor's] communications with [the mother] displayed a lack of sensitivity and he treated [her] with a striking lack of empathy."
The tribunal hearing is expected to finish later this week.