Cerebral Palsy Caused by a Doctor’s Failure to Perform a Timely Cesarean Section
Obstetricians are trained to identify issues which may complicate the pregnancy or delivery and mitigate such risks, often by performing a cesarean section. In many cases, delaying or failing to perform a needed C-section could result in the development of cerebral palsy.
The delivery of a child is a critical time where prompt and attentive medical care is essential. In some cases, doctors know early on in the pregnancy that certain risk factors necessitate a cesarean section delivery. In other cases, doctors must make the decision to perform an emergency C-section in order to save the life of the child and/or mother.
Signs of fetal distress (e.g., a decreased or irregular fetal heart rate, low blood pressure, etc.) observed during labor or late stages of pregnancy may necessitate an emergency c-section in order to facilitate a healthy delivery. It’s estimated that around 1 in every 159 pregnancies result in an emergency C-section delivery.
Failing to perform a timely C-section, when warranted, could put the child at an unnecessary risk for the development of a serious brain injury, and could open the hospital up to liability when it comes to a medical malpractice claim filed by the family.
In general, cerebral palsy is caused by a birth injury resulting in permanent damage to the child’s brain. Brain damage to a baby during childbirth is generally caused by fetal asphyxia (where the child’s oxygen supply is cut off) during labor, whether it be a normal vaginal birth, a cesarean section birth, or a vaginal birth after cesarean (VBAC).
Assessing Pregnancy Risks Early
Prenatal doctors must assess your overall risk factors way before labor in order to determine whether or not a vaginal delivery is safe. This is done by reviewing your medical history, family medical history, as well as physical exams to spot anything that may predispose you to a high-risk pregnancy or difficult delivery.
Potential risk factors can vary, but generally include diabetes, high blood pressure, STDs, multiple births (twins, triplets), a history of prior C-section deliveries or childbirth complications, cephalopelvic disproportion, certain maternal infections, a nuchal cord, placenta previa, and Rh disease.
Failure to identify such risk factors and schedule a cesarean delivery may constitute medical malpractice if it can be shown by the family’s attorney that the doctor’s level of treatment fell below the accepted standard of practice in the medical community.
Emergency C-Section Delivery
The American College of Obstetricians and Gynecologists recommends a 30-minute “decision-to-incision” rule, meaning that all hospitals offering obstetrical services should be able to perform an emergency cesarean section within 30 minutes of the decision to operate. With some types of pregnancy complications, however, every minute counts. If signs of fetal distress are observed, it is imperative that a C-section is performed as soon as possible to reduce the risk of a permanent brain injury.
Careful monitoring of the heart rate and oxygen levels of the baby are essential during labor and delivery. Any signs of fetal distress could mean he or she is not receiving enough oxygen. If the child’s brain goes without an adequate oxygen (blood flow) supply for several minutes, the baby could suffer from hypoxic-ischemic encephalopathy which could lead to the development of cerebral palsy.
The longer the medical staff delays the performance of an emergency C-section, the higher the potential for complications. This includes the possibility of brain damage that results because of a lack of oxygen, various physical injuries, and even wrongful death.
Complications which may necessitate an emergency cesarean section delivery:
- Uterine rupture — A tear in the uterus during delivery, which can cause hemorrhaging and oxygen deprivation to the unborn baby.
- Placental abruption — This occurs when the placenta separates from the uterine lining, cutting off the oxygen and nutrient supply to the baby.
- Umbilical cord prolapse — This occurs when the umbilical cord presents before the baby. A vaginal delivery could result in the cord becoming compressed, cutting off the child’s blood supply.
- Breech birth — Where the child presents in the breech position (buttocks or feet first), it can increase the chances of injury to the child’s brachial plexus nerves, broken bones, and fetal asphyxia.
- Lack of cervical dilation — In some cases, labor may not progress to a point where the cervix will fully dilate.
Risks to the Mother and Child
Even though there have been advances in medical technology that make C-sections safer, as with any surgical procedure (and childbirth itself), there is always risk to the mother and child — whether or not a c-section is performed.
In many cases, the most-serious risks come from failing to perform an emergency c-section in time, as well as anesthesia complications (incorrect dosage, allergic reactions, etc). The mother may also suffer complications such as infection and hemorrhaging.
When it comes to the child, the biggest risks are death and permanent brain damage. Any damage to a child’s developing brain can result in serious neurological disorders, including cognitive disabilities and the development of cerebral palsy.
If you believe that your child’s cerebral palsy was the direct result of a missed or delayed C-section delivery, you may wish to discuss the facts of your case with a cerebral palsy attorney for more information about your legal rights.