Childbirth at one time was an experience that took place exclusively in the home. Women gave birth attended by a midwife, sisters, friends and other women in the neighborhood or community. The collective birth knowledge of the community was shared among women. As technology and medicine evolved, new ways of preventing maternal and infant mortality caused a shift and drew childbirth into the realm of the hospital. What was once an intimate family affair became medical, sterile and regulated. But in many ways, childbirth became very dangerous once medical professionals dictated it.
When did birth get risky?
Although there are inherent risks of childbirth, the History of Midwifery and Childbirth shows some risks increased and new risks were invented when childbirth moved from the realm of home to the realm of the hospital. For example, Childbed Fever was a complication that wasn’t seen until doctors began seeing multiple patients confined in a hospital childbirth ward, and it killed new mothers. As it turned out, it was simply the spread of the streptococci virus that was passed from woman to woman by doctors performing internal examinations without washing their hands [i].
Factors that Increase the Risk of Birth Injuries
The following increase the risk of birth injuries to newborns:
- Macrosamia – When the fetal weight is greater than 4000 g, the likelihood of birth injuries rises as the fetal size increases.
- Maternal obesity – When the mother has a body mass index higher than 40 kg/m2there is an increased risk of birth injuries.
- Abnormal fetal presentation – If the baby is in any position other than a vertex (head down) position, particularly breech presentation (feet or buttocks first), this carries an increased risk of birth injury with vaginal delivery.
- Operative vaginal delivery – When the clinician uses forceps or a vacuum device to assist the mother in delivering the baby.
New Devices, New Trauma
If forceps and vacuums were created to assist mothers with difficult deliveries and actually make childbirth safer, why is there a greater risk for birth injury? What happens is “the instrument is applied to the fetal head, and then the clinician uses traction to extract the fetus, typically during a contraction while the mother is pushing” [ii]. These devices can cause bruising and lacerations to the head of the baby, and the traction and force used to extract the baby can lead to nerve damage and severe, long-term injuries such as brachial-plexus injury.
What is Shoulder Dystocia?
Shoulder dystocia occurs when a baby’s shoulders become lodged in the birth canal during a delivery. Once the baby crowns and the head is delivered, the baby typically performs a natural and instinctual rotation, making it easier for the shoulders to pass through. Some babies, though, have difficulty with this. When the shoulders do not pass easily through the birth canal, the baby is at risk for oxygen deprivation and many other complications. The physician and medical team are under immense pressure to get the baby out quickly and safely. This is one reason a doctor may turn to brute force or the help of medical instruments to deliver the baby as quickly as possible. This pressure to get the baby out quickly is the very thing that can lead to negligence and injury.
Negligence and Shoulder Dystocia
For an OBGYN to be considered negligent in a shoulder dystocia case, his or her wrongdoing would fall under one of two categories:
- Before the birth, during prenatal care, the doctor failed to diagnose a risky condition that should have signified the need for a C-section to deliver the baby safely.
- During the delivery, while the infant was trapped in the birth canal, the caregiver ignored signs of fetal distress and failed to employ specialized maneuvers designed to facilitate passage of the baby past the mother’s pelvic bone.
What can you do?
To get the answers you seek for you baby’s shoulder dystocia case, you might choose to pursue a birth injury law firm such as Teal & Montgomery to conduct a detailed investigation. If your child obtains a cash award, it may be applied toward surgery, therapy or training that can help the baby improve or cope with the shoulder dystocia.
Contact A California Birth Trauma Lawyer
Our team of dedicated, skilled medical malpractice attorneys in Sacramento and Santa Rosa includes a doctor who is also a lawyer. The entire law firm of Teal & Montgomery is prepared to place a high priority on excellent, effective preparation of your case.
Please contact us online today or call 916-448-1010 to schedule a free initial consultation to discuss your options. We can visit you in your home or hospital if you need us to.
[i] Feldhusen, A. (2000, January 1). The History of Midwifery and Childbirth in America: A Time LinePrepared by Adrian E. Feldhusen, Traditional Midwife. Retrieved February 28, 2015, from http://www.midwiferytoday.com/articles/timeline.asp
[ii] McKee-Garrett, T. (n.d.). Neonatal birth injuries. Retrieved February 28, 2015, from http://www.uptodate.com/contents/neonatal-birth-injuries