When we go to the doctor or are admitted to a hospital, we have every right to expect that medical professionals will take care of us. This is especially true during the birth of a child. While birth is a beautiful moment, it can also be a potentially dangerous one. That's why we reasonably expect obstetricians, labor and delivery nurses, and other medical providers will carefully monitor the health and safety of the mother and baby.
What families can do in resopnse
Of course, medicine is not an exact science. No two births happen exactly the same way. Judgment calls and split-second decisions have to be made. We do not and cannot expect doctors and nurses to be perfect, but we do expect them to do their jobs competently.
That's what we mean when we talk about a "standard of care."
What is a standard of care?
First, it's important to understand that a standard of care is a legal rather than medical term. The law expects individuals to exercise reasonable caution and avoid causing injury to others, whether they're at home, on the road or on the job. In medical negligence cases, including birth injuries, the standard of care for doctors and other medical professionals is usually defined as:
The normal level of care and skill of the average health care provider who practices that provider's specialty, taking into account the medical knowledge and information available to the provider at the time of the incident.
In other words, if an obstetrician delivers a baby and that baby is born with an injury, it's possible to determine whether the obstetrician failed to meet the standard of care by looking at what an average obstetrician would have done in the same situation with the same available information. Failing to meet a standard of care is called negligence - which means potential liability in a malpractice claim.
Examples of medical negligence during birth
Obstetricians and other medical professionals who are involved in the birthing process have well-established standards that determine the type of care that should be given in different situations. Those standards are not always met. Examples of negligence include:
Incorrect administration of labor-inducing drugs. Doctors often use medication to either induce labor or enhance labor when contractions are already happening but not quickly or regularly enough. There are several medications that can be used to induce labor, and they need to be administered in the correct dosage and by the right route (for example, oral, vaginal or through an intravenous (IV) needle). Malpractice can occur when a doctor administers such a medication in the wrong dosage or by the wrong route; for example, an overdose of a labor-inducing medication can cause excessive contractions that reduce the supply of oxygen to the baby's brain. Failing to induce labor or waiting too long to administer the medication when it is medically necessary to do so (for example, because of an infection) can also be a breach of the standard of care.
Failure to monitor. One of the most important aspects of labor and delivery is monitoring the fetal heart rate. In general, a healthy fetal heart rate is between 110-160 beats per minute, and some fluctuation within this range is normal. A heart rate below 110 beats per minute can be indicative of oxygen deprivation, which can cause brain damage, while a heart rate above 160 beats per minute can put the baby at risk of cardiovascular failure. Medical professionals have a responsibility to monitor the fetal heart rate, correctly interpret information and take all medically necessary steps to address signs of distress.
Delayed c-sections. A caesarean section (surgical delivery) is a major surgery that doctors and mothers alike generally prefer to avoid whenever possible, and for good reason. The reality is that under certain circumstances, a prompt c-section is needed. For example, at the first sign of fetal distress (lack of oxygen to the baby's brain), a c-section is needed to mitigate brain damage and prevent serious birth injures, such as cerebral palsy. Failing to order a c-section when it is medically indicated is a breach of the standard of care.
These are just a few examples. There are many, many other standards of care that apply to childbirth, and when any standard of care is breached, the consequences can be catastrophic.
Families of children harmed by negligence have legal recourse
Not every birth injury is caused by negligence. It is entirely possible for an obstetrician to follow every single standard of care and still have the birth result in an injury that could not have been foreseen or prevented. That being said, doctors and hospitals are often quick to deny responsibility for injuries that could have been prevented if they had followed established standards of care. When a birth injury occurs, families need to ask questions and follow up to find out what happened.
When a birth injury occurs as a result of medical negligence, the medical provider can be held accountable through a malpractice lawsuit for damages (financial compensation) to pay for the treatment, long-term care and services the child will need as a result of the injury. Such lawsuits are governed by state law and thus vary from state to state. In general, the victim's attorney needs to thoroughly investigate each complaint in order to construct a complete narrative of what happened during the birth, identify the action(s) or inaction(s) on the part of a medical provider that caused the injury, and retain a medical professional in the same specialty to testify that the standard of care was not met. Because different statutes of limitations (legal time limits) can apply to birth injury cases depending on the circumstances and the jurisdiction, the best course of action is to seek legal help as soon as possible.