More effort needed to prevent in utero birth-related injury malpractice lawsuits

A midwife friend recently called me to tell me that she had been named in her first lawsuit. She was shocked and obviously upset. She described the family that filed suite as sweet and friendly, the last people she would imagine suing her.

The birth in question happened more than two years ago and was, to the midwife's recollection, uneventful. Apparently the child suffers from some disabilities now that someone has linked to possible birth trauma. 

As I counseled my friend, I recalled some words of wisdom shared by a seasoned midwife when I was in school. This midwife had said that in obstetrics it isn't a matter of if you will get sued, but when. She also cautioned us as providers not to take it personally when it happened. Her point was that anyone with a disabled child would do anything possible to ensure that the child is well cared for during his or her lifetime. 

As the mother of a disabled child, I understand the desire to ensure future wellbeing and a lifetime of care. My son is autistic though, so I can say with relative certainty that no one caused his disability — not my midwife, her collaborating physician or the pediatrician. Until a definitive cause of autism is found, I have no one to blame. 

As an obstetrics provider, I get very upset when I see the numerous commercials for medical malpractice attorneys promising to get families what they deserve for their birth-related injury. It is not surprising though considering that we live in a blame-oriented society where personal responsibility is a rarity. Thanks in large part to ambulance-chasing lawyers, obstetricians are leaving the field in record numbers, unable to afford the overwhelming cost of malpractice insurance. 

Every pregnancy, labor and birth carries some risk. Moms and babies can suffer injuries or illness that are not the provider's fault. More research is pointing to in utero causes for disabilities like cerebral palsy and even brachial plexus palsies, which were previously linked only with birth-related injuries.   

That's not to say that birth injuries never happen — they do. But the blame for all birth injuries cannot be placed solely on the provider. 

For example, I've seen lawsuits filed in cases of shoulder dystocia in non-compliant gestational diabetic mothers. Is this really solely the fault of the provider? Doesn't the mother share some of the blame for not safely controlling her blood glucose levels? 

Getting sued is a fear of most every obstetric provider I know. I've seen law suites destroy the confidence and careers of midwives and physicians alike. According to most experienced providers it is a harsh reality of the medical profession, especially in the field of obstetrics. Our hope may lie in tort reform or maybe in the growing medical evidence for in-utero injuries that precede delivery. 

Just as someone needs to protect and defend babies who are truly injured at birth or by the fault of a provider, the field of obstetrics needs a champion. Something must change in medical malpractice law before we lose all of our providers. 

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