Medical Malpractice During Childbirth: A Legal Overview

An injury to a mother or her newborn during childbirth can lead to a medical malpractice lawsuit, but only if a health care provider provided substandard care.

Updated by , J.D. · University of San Francisco School of Law
Updated by Stacy Barrett, Attorney · UC Law San Francisco

Some injuries to mothers and babies during the labor and delivery process are unavoidable. But other injuries can be prevented if doctors and other medical professionals provide appropriate and timely care. This article will focus on potential medical malpractice liability for birth injuries.

Injuries to the Mother During Labor and Delivery

According to the World Health Organization (WHO), about 287,000 women died during and following pregnancy and childbirth in 2020. Mothers can suffer harm when health care providers fail to prevent or manage complications, including:

Birth Injuries to a Child

During the birth process, a baby may suffer a physical injury. Some birth injuries are simply the result of being born. Other birth injuries can and should be prevented with proper and timely health care. Here are some of the most common birth injuries that may lead to a valid medical malpractice claim.

Caput Succedaneum

Caput succedaneum is the swelling of a newborn's scalp, usually caused by pressures on the baby's head during a difficult or prolonged head-first delivery. Caput succedaneum can also occur during a vacuum extraction procedure. Visual bruising sometimes accompanies the swelling, but the condition frequently goes away within a few days following childbirth.

Cephalohematoma

Cephalohematoma involves bleeding under the baby's scalp and is another type of birth injury that can result from vacuum extraction. A cephalohematoma will often disappear on its own within a few weeks or months after birth and rarely requires treatment.

Neonatal Brachial Plexus Palsy

Brachial plexus refers to a group of nerves around the baby's shoulder. Depending on the position of the baby during birth, pressure on the baby's arms, or stretching of the baby's shoulders can cause damage to the brachial plexus. If damage exists, there could be a loss of movement or weakness in the baby's arm.

Hypoxic Ischemic Encephalopathy

When the baby's brain does not receive enough oxygen or blood flow for a period of time, hypoxic-ischemic encephalopathy (HIE) can occur. HIE is a type of brain disorder that can have a range of effects, from mild developmental problems to cerebral palsy or epilepsy. The severity of HIE depends on how long the child's brain goes without oxygen.

Bone Fractures

Newborn bone fractures are among the more common birth injuries. According to Standford Medicine, fracture of the clavicle or collarbone is the most common fracture during labor and delivery.

Skin and Soft Tissue Injuries

During delivery, a baby's skin can become injured due to pressure from contractions or a doctor's medical instruments. These injuries often present themselves as bruising or swelling.

Death

Labor and delivery injuries that result in the newborn's death are the most emotionally charged and legally complex of all childbirth medical malpractice cases, and can lead to the filing of a wrongful death lawsuit.

When a Birth Injury Can Lead to a Lawsuit

The injuries detailed above are not always the result of medical negligence on the part of a doctor, nurse, or hospital. Determining whether legal liability exists usually means applying medical malpractice law to the facts of the case, via a four-step process.

Step One: Establish the Medical Standard of Care

The first step is establishing the appropriate medical standard of care that applied to the situation in which the mother or child was injured. For example, if the person being sued (the "defendant") is an obstetrician, the court would compare the defendant's actions to those of a similarly-skilled and trained obstetrician in a similar community or setting—not to an emergency room surgeon, oncologist, or advanced practice registered nurse with a specialty in women's reproductive health. The person suing (the "plaintiff") will typically rely on a qualified medical expert to testify as to the proper medical standard of care.

The appropriate level of care also takes into account the medical information available to the health care professional at the time of the injury. Courts recognize that it's not fair to use hindsight to hold providers legally liable for something they couldn't have known at the time an injury took place.

Step Two: Measure the Health Care Provider's Actions Against the Standard of Care

Once the appropriate standard of care is established, the health care provider's actions are measured against that standard. Here a medical expert will take a detailed look at what was actually done during the labor and delivery process, and what would have been done by a similarly-skilled care provider, based on all the facts and information reasonably available at the time.

Step Three: Decide Whether the Substandard Care Caused the Injury

Step three involves deciding whether the health care provider's deviation from the standard of care was the legal cause of harm to the mother or baby. For example, perhaps the doctor failed to recognize complications during a vaginal birth and promptly order a cesarean section. But is the doctor's mistake the reason why the baby was stillborn? If the baby would have passed away regardless of the doctor's mistake, then there is no legal causation and therefore, no medical malpractice liability.

Step Four: Calculate Damages

The last step involves identifying and calculating the plaintiff's injuries and other losses ("damages") resulting from the medical malpractice. Practically speaking, most plaintiffs wouldn't bother bringing suit unless they had sufficient damages to justify the time and expense of filing a medical malpractice lawsuit. That won't stop the defendant from disputing the nature and extent of damages claimed by the plaintiff in many cases.

Talk to a Lawyer

If you're thinking about taking legal action over harm caused by a health care provider's mistake during labor and delivery, talk to a lawyer. A lawyer can answer your questions and explain your legal options. Medical malpractice cases are complex and difficult to prove. You'll want the right medical malpractice lawyer on your side. When you're ready, you can connect with a lawyer directly from this page for free.

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