A mother whose newborn baby died after hospital staff failed to wake her for checks before he was born told an inquest she felt "terrified and alone".
Eve Taylor, 29, was admitted to Ysbyty Gwynedd, Bangor, after her waters broke early at 36 weeks and was identified as having signs of potential infection.
She was due to be monitored again later that night, but a midwife decided not to wake her up. Taylor awoke hours later and was rushed for an emergency C-section.
Sonny Taylor died of a brain injury three days after being born on 3 October 2022, with a coroner saying his death was preventable.
Betsi Cadwaladwr University Health Board has apologised and admitted failings in care.
During a full inquest hearing at Caernarfon, the coroner's court heard how initial monitoring showed both mother and child were well, with antibiotics given in case of an infection.
In a statement read out in the hearing, the mother said she later woke up "feeling an intense fear".
"Instinctively, I felt that something was wrong and I needed help," she said.
Taylor told a midwife that her baby did not appear to be moving as usual.
The maternity team discovered the baby's heartbeat was very low, and an emergency C-section was carried out.
"Everything seemed rushed and out of control. I felt that the staff were frantic with little organisation," she said.
The hospital then moved the mother to the labour ward rather than directly to an operating theatre, leading to a further delay in delivering the infant.
Taylor said there was "panic" with staff arguing with each other and her son was born in "poor condition" just after 02:00 in the morning.
She was told he was very unwell with a possible brain injury.
Sonny was then transferred to the special care baby unit at Glan Clwyd Hospital, but despite intensive care, he died three days later.
The cause of death was a brain injury due to oxygen starvation, along with a sepsis infection, the court was told.
Taylor said she believed Sonny's death could have been prevented, and had she been woken up to be monitoring then the outcome would have been different.
Delivering a narrative conclusion, senior coroner Kate Robertson agreed with her view.
Robertson said had the missed monitoring taken place that evening, and the mother been sent straight to surgery when concerns were raised, the baby would have been delivered earlier.
"Sonny's death would not have occurred at this time," she said.
Giving evidence to the hearing, members of the health board's clinical teams said the case had led to widespread changes and learning for its maternity teams across north Wales, including training, record keeping and decisions on monitoring.
Karen Roberts, the head of midwifery nursing, said an audit now showed where monitoring of mothers was required, it happened "100%" of the time, and a mother would now always be woken if needed.
It also emerged during the hearing that concerns about the infant's death were not referred to the coroner at the time.
Robertson said the matter came to her attention following media reports after the health board apologised to the child's parents for failings.
The coroner said that was "entirely regrettable" that it had taken four years for the inquest to be held and may have re-opened "an incredibly traumatic time" for the parents.
