Caesarean sections are utilized (and sometimes over-utilized) in the United States as an alternative to vaginal delivery. There are several situations in which a caesarean section (“C-Section”) is necessary for the health and safety of mother or child. In these instances, failure to perform the Caesarean section may be the result of medical negligence and may result in significant injury to either the mother or the child.
A Caesarean section delivery is frequently scheduled in advance of the due date, as a result of a medical indication, or, less frequently, for the convenience of the mother, as an alternative to a vaginal delivery. A Caesarean section is a surgical procedure, and the basis for the usual decision to schedule the procedure involves a risk/benefit calculation based upon medical evidence.
Some indications for Caesarean section include previous delivery by Caesarean section, presence of a serious bloodborne infection in the mother that could be transmitted to the child during a vaginal birth, or a chronic maternal medical condition, which might result in harm to the mother while undergoing the physical stress of a natural labor and delivery.
Malpresentation, known as breech position, late in the pregnancy often results in Caesarean section to avoid any potential complications. If the fetus has an intrauterine anomaly or disorder, including hydrocephalus (excess fluid around the brain) or in the event that another significant congenital problem is detected before birth, a Caesarean section may be performed for the health of the infant. Under these circumstances, the procedure is planned several weeks prior to the estimated date of confinement, or due date.
Indications for Emergency C-Section
Complications that occur during labor or delivery may result in significant problems, and the attending physician must be prepared to operate quickly at any point in the mother’s labor. Specific problems during labor and delivery include failure to progress in labor, whether due to difficulty resulting from the size of the baby’s head in relationship to the birth canal, or to fetal distress indicated by heart rate changes on electronic fetal monitoring used in the labor and delivery suite. Changes in fetal heart rate are sometimes the result of fetal hypoxia. If the fetus is not receiving an adequate supply of oxygen, every moment counts and delivery must be rapidly performed.
A specific situation in which delivery must be quickly performed occurs due to a condition called placental abruption. This condition is characterized by separation of the placenta from the uterus prior to delivery. The mother can rapidly exsanguinate, or bleed out. The infant cannot survive due to lack of oxygen carrying blood from the placenta. This is a true obstetrical emergency.
Placenta previa is another situation that may require Caesarean delivery. Placenta previa is usually characterized by painless bleeding in the second or third trimester of pregnancy. In placenta previa, the placenta, a fleshy, disc shaped organ that provides nutrients and oxygen carrying blood to the fetus, covers the opening of the mother’s cervix (cervical os) either partially or fully. This condition is less life-threatening than placental abruption, but results in problems during delivery. Bleeding may be significant.
There are conditions that occur unexpectedly, and these unpredictable problems that prevent an uncomplicated delivery include shoulder dystocia, a condition in which the should of the infant becomes trapped behind the maternal pubic bone, preventing a timely delivery and potentially compressing the umbilical cord, cutting off the flow of oxygen to the fetus. The body’s cells die quickly without oxygen, and the result of failure to execute a rapid Caesarean section is frequently a devastating brain injury or even death of the fetus.
Another problem encountered during delivery is prolapse or any type of compromise of the umbilical cord that cannot be easily resolved. In these cases, if routine maneuvers fail to resolve the problem, delivery must be undertaken immediately because of fetal compromise due to lack of oxygen.
If healthcare providers fail to monitor the mother and fetus during labor, there is a potential to miss signs of distress. When the labor is allowed to continue too long. fetal distress may result. A physician may miss the signs of distress, because of either ignorance or negligence.
In some cases, the obstetrician may have failed to recognize a medical condition in the mother that is an indication for a high-risk delivery requiring Caesarean section. Other mundane but unfortunate reasons for delay of a Caesarean section include poor staffing and problems with insurance that delay appropriate care. There are many unfortunate occurrences that may result in the tragic death of mother or child, or in a lifelong disability such as cerebral palsy or Erb’s palsy (an injury to the nerves that supply the upper arm as a result of shoulder dystocia.)
There are clear standards of care in this area, and if a physician fails to adhere to standard medical practice, he or she is negligent. If you have suffered injury personally or if a delayed Caesarean section has resulted in injury to your child, you potentially face years of special medical care and disability.
In the event of birth injury due to delay of a necessary Caesarean section, you may be entitled to receive compensation for your losses. An attorney who is experienced in medical malpractice, or specifically with experience in birth injuries, will be able to help you evaluate your options as you seek compensation for ongoing and future medical expenses and other damages in the event that your physician was negligent in providing adequate care. If you have any questions, call Passen & Powell at 312-527-4500 to discuss.