Childbirth, one of the most anticipated and anxiety-inducing medical experiences possible, has thankfully become much less terrifying due to modern medicine; between 1915 and 1997, the infant mortality rate declined to 90%, and the maternal mortality rate declined to almost 99% in the U.S.[1] However, fears regarding the event are still pervasive, and for good reason; in 2012, about 5 to 7 of every 1,000 births in the United States resulted in some sort of birth trauma, many of which are due to errors made by health care professionals.[2] Why do these errors still occur and how can they be prevented? As experts in interpreting medical records, discovering discrepancies, and explaining the expectations medical professionals are held to during childbirth care, we can help you better identify what went wrong and why. Here is a brief overview of the what, they why, and the how:

 

The different kinds of errors

Birth-related errors fall into three categories: wrongful pregnancy, wrongful birth, and mother or infant injuries. Wrongful pregnancy cases occur when parents aimed to avoid pregnancy – through sterilization, pregnancy testing, or abortion – but those methods failed due to medical staff or doctor negligence.[3] Wrongful birth cases relate to instances where parents claim their doctor failed to warn them about their child’s imminent birth defects or other circumstances that might have caused them to avoid or terminate the pregnancy.[4] Finally, during childbirth, there are instances where temporary or permanent harm is done to either the mother or the child. Here are some of the most common errors in this category:

  • Failure to monitor or detect problems with fetal heart rate, oxygen levels, or other vitals
  • Failure to order a timely caesarean section
  • Incorrect or inappropriate use of a delivery tool
  • Incorrect medication or dose
  • Failure to identify or treat an infection
  • Failure to diagnose potential birth complications
  • Incorrect or inappropriate delivery techniques[5]

 

Why they happen

Though there can be many reasons for a birth-related error, mistakes are most frequently caused by problems in communication between members of the birthing team.[6] As mentioned many times in our other posts, communication between medical team members is essential to the success of the task at hand, and when there is a lack of direct communication, problems are much more likely to occur. Other common causes of birth-related injury include over-use or misuse of labor-inducing drugs, unnecessary use of forceps or vacuum extraction, missed signs of fetal distress, improper resuscitation technique, and delayed c-sections.[7]

 

How they can be fixed

To improve communication, medical staff members can be trained together so that they have the same understanding and expectations of medical procedures while also learning to trust and share more with their coworkers. Additionally, SBAR (Situation Background Assessment Recommendation) is a briefing strategy that can be used to improve nurse-physicians communication, especially during shift changes.[8] Additionally, medical staff members need to ensure they are following standards of practice, such as the following:

  • Mothers must be hooked up to a fetal heart monitor within one hour of entering the hospital for delivery; if any problems develop with the monitor, an internal monitor should be used in replacement
  • A woman in the labor and delivery room should have an IV inserted, even if no fluids are expected to be needed
  • If the baby’s baseline heart rate drops below 110 for 60 seconds or longer, a physician must be called and arrive within 30 minutes
  • If a woman in labor is placed on oxygen or advised to lie on her left side, she should be seen by a physician within 30 minutes
  • Parents need to be consulted and informed of the risks prior to the use of vacuum or forceps[9]

 

Though the improvements to a mother and baby’s situation in a delivery room have improved drastically even in the past fifty years, there are still risks that can’t be forgotten. If you have a case involving a birth-related error, let us know if our experts can help to clarify records, events, and moments where mistakes may have been made. Only from better communication with all do these errors have the chance to disappear.

 

[1] “Achievements in Public Health, 1900-1999: Healthier Mothers and Babies,” cdc.gov, n.d., https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm

[2] “Labor and Delivery Errors and Cover-Ups: How to Identify Them and Get Help,” ABC Law Centers, April 24, 2012, https://www.abclawcenters.com/blog/2012/04/24/labor-and-delivery-errors-and-79865/

[3] Boeschen, Coulter, “Birth-Related Medical Malpractice,” NOLO.com, n.d., http://www.nolo.com/legal-encyclopedia/birth-related-medical-malpractice-30150.html

[4] Ibid

[5] “Labor and Delivery Errors”

[6] “Communication Errors are #1 Cause of Preventable Birth Injuries,” HG.org, n.d., https://www.hg.org/article.asp?id=29759

[7] Ibid

[8] Ibid

[9] “Possible Signs of Medical Error during Labor and Delivery,” CP Family Network, n.d., http://cpfamilynetwork.org/medical-error-during-labor-and-delivery/