Medical Malpractice During Childbirth: A Legal Overview

If a health care provider's negligence causes injury to a newborn or mother, there could be medical malpractice liability.

When something unexpected happens during the labor and delivery process, the mother or baby might suffer injuries that are unavoidable. But in other situations, harm might be preventable if doctors and other medical professionals provide appropriate and timely care. This article will focus on the types of injuries that can occur during childbirth, and the potential medical malpractice liability that can result.

Injuries to the Mother During Labor and Delivery

While most birth injuries affect the child, mothers can also suffer harm when a doctor does not take proper action during childbirth, including:

  • untreated or undetected preeclampsia that leads to a mother’s seizure during delivery
  • leaving medical equipment or disposable medical supplies inside the mother following a cesarean section
  • uterine rupture
  • infection
  • damage to a mother’s internal organs from surgical instruments during a cesarean section
  • complications from anesthesia, and
  • failure to control bleeding.

Birth Injuries to a Child

In this section, we take a closer look at some of the more common injuries that affect newborns. Note that not all of these injuries will result in 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. Bones that periodically become fractured during the birth include the collarbone and the upper arm bone.

Some of these fractures can occur during a normal childbirth and heal on their own. Other times, fractures may be facilitated by a genetic condition.

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.

The fat under the baby’s skin can also become injured. These injuries can appear as raised, red areas on the body. This is often subcutaneous fat necrosis and like most skin injuries, will resolve on its own without treatment.

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 or nurse. Determining whether legal liability exists usually means applying medical malpractice law to the facts of the case, via a four-step process.

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 instance, if 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 plaintiff's lawyer will usually 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 a doctor legally liable for something they couldn’t have known at the time the injury took place.

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 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.

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.

If you're thinking about taking legal action over harm caused by a health care provider's mistake during labor and delivery, it may be time to discuss your situation with a lawyer and determine your best course of action. Use the contact tools on this page to reach out to a medical malpractice lawyer near you, or learn more about finding the right medical malpractice lawyer for you and your case.

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