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Birth injury (mother)

Pregnancy and giving birth are considered to be one of the most wonderful times in a woman’s lifetime. It should be a time of excitement and joy for all families.

In England and Wales alone 1,800 babies are born on average every day and the UK is one of the safest places in the world to give birth.

The expectant mother is normally monitored before, during and after birth collaboratively by means of Primary Care and Secondary Care. Some babies are born at home but the majority of babies are born in a hospital (private or NHS). If the expectant parent opts for a home birth, care will carried out by community midwifery teams. In a hospital the Delivery Ward have a multi-disciplinary team who all work together to ensure the delivery (with or without medical assistance) of a baby is comfortable and safe with the highest level of care possible. The maternity hospital staff (in terms of the mother) will consist of midwifes, obstetricians (doctors specialised in pregnancy and birth), anaesthetists (they will give epidurals and provide anaesthesia for caesarean sections), maternity support workers, obstetric physiotherapists and gynaecologists. In the hospital setting if the pregnancy has progressed normally and a normal birth expected a midwife will generally look after the expectant parent and deliver the baby vaginally. If any complications have developed during a pregnancy, during the labour or if a caesarean section is needed an obstetrician (and theatre staff) will be involved in the labour and birth.

All health professionals involved the maternity care of expectant mothers from early pregnancy through to postnatal care are highly trained with a duty of care to monitor patients as effectively as possible following established standards of care and most babies arrive without complication. Pregnancy and childbirth always carries risk for the expectant mother. The main risk factors that can potentially lead to complication are large babies, breach positioned babies, assisted births, long deliveries, short deliveries and comorbidities of the mother. Occasionally unavoidable complications do occur through no fault of the healthcare professionals involved in the care of the mother. For example, with vaginal births perineal tears are almost expected – 3 out of 4 mothers will have some kind of tear with around 75% requiring stitches. Hence tears are usually unpreventable and happen spontaneously during birth but the correct steps are taken to minimise the risk, repairs routinely performed without issues and healing progresses without complication. Psychological issues are also not uncommon in ‘normal’ pregnancies or the postpartum period and 1 in 5 women experience mental health issues either whilst pregnant or in the first 12 months after giving birth. Maternal death is very low in the UK (1 in 10,000 pregnancies) the leading causes being cardiovascular disease and strokes with a small number of maternal deaths caused by unavoidable obstetric emergencies.

However, sometimes the care a mother receives from the healthcare professionals she has put her trust in during pregnancy, labour, birth or just after birth does fall below what is expected with preventable mistakes resulting in injury to the mother. These injuries sustained can be physical or / and psychological. Devastating injuries caused by clinical errors of the medical professionals involved in the management of pregnancy or the delivery of a baby can significantly impact on life after the birth. Such impacts include a mother having to give up working or career leading to loss of earnings, relationships with partners and children can be detrimentally affected and the requirement of further treatment which can be ongoing can impact further on quality of life. Injuries caused by pregnancy or birth can have a tragic effect on the physical and mental health causing lifelong damaging consequences on the quality of life for the mother and their family. Occasionally, clinical error in pregnancy or childbirth can lead to the death of the mother. This is all clinical negligence.

Pregnancy and Birth Injury (mother) clinical negligence means the care you received during your pregnancy, labour, birth or post-natal period fell below medically acceptable standards and this directly injured you either physically or / and psychologically. Clinical negligence injuries can be short-term or long-term. When this happens you may have cause for a clinical negligence claim.

  • Common Pregnancy and Birth-related Mother Injuries claims
    • Undiagnosed ectopic pregnancy

    A failure to diagnose quickly and treat an ectopic pregnancy appropriately can lead to life-threatening illness.

    • Undiagnosed or unreasonable delay in diagnosis and/ or management of underlying conditions

    This includes pregnancy related conditions such as Pre-eclampsia and Gestational Diabetes or post-partum conditions which left undiagnosed, diagnosed late or treated incorrectly can potentially lead to life threatening illness such as eclampsia.

    • Unreasonable delay in diagnosis and treatment of serious infection

    This means a failure to rapidly diagnosis and treat serious acute or critical infection in the prenatal, perinatal and postnatal stages of childbirth.

    • Epidural Anaesthesia Injury

    Around a third of women choose an epidural to relieve pain in vaginal births and they are also used for pain relief in caesarean section delivery. Administered by an anaesthetist injury can occur at any stage of the epidural procedure – inadequate consent, risk screening or preparation of the epidural, incorrect insertion or removal of the anaesthetic needle, inappropriate or incorrect administration of the anaesthetic or inadequate monitoring after the catheter is removed. Preventable physical injuries (e.g. paralysis, spinal cord nerve damage, allergic reactions, hypotension and cardiac arrest) can have long lasting impact.

    • Forceps Injury

    The incorrect use of forceps can lead to serious injuries such as a perineal tear, blood clots and incontinence.

    • Caesarean Section (C-Section) Injury

    Caesarean section delivery is usually performed when a vaginal birth could be potentially dangerous to the baby or mother. 1 in 4 babies in the UK are now born by caesarean section. A caesarean section (elective or emergency) is an operative procedure and so does have risks (as with any abdominal surgery) but they are generally very safe with most babies born healthy and most mothers recovering without serious complication within 6 weeks. Negligent injuries to the mother related to caesarean section procedures can range from negligence pre-operatively (e.g. failure to preoperatively assess adequately or intervene in a timely manner) , peri-operative injury (e.g. poor anaesthetic administration, reaction to general or epidural anaesthesia, allergic reaction medication or latex, injury to the bladder or bowel such as vaginal fistulas, nerve damage, blood clots, surgical instruments / retained swabs and occasionally maternal death) or post-operative care leading to injury (e.g. post-surgery wound infections, endometritis, hospital acquired infections and sepsis, postpartum haemorrhaging (PPH) requiring a blood transfusion or emergency hysterectomy, preventable scarring, and complications in future pregnancy or birth).

    • Perineal / Vaginal Tears / Episiotomy Injury

    High Grade (3rd and 4th degree) tears which could have been avoided due to lack of assessment to minimise the risk of a tear, delay or failure to perform or poorly performed episiotomy, delay or failure to diagnose a tear during childbirth, failure to repair a tear or tears that have been surgically poorly repaired or poorly managed post-surgery (for example post-surgical infection or failure to being referred to a physiotherapist) could all be a negligent birth injury. Such tears can lead to urinary and faecal incontinence, fissures and fistulas, infection, colostomy bags, nerve damage and future babies having to be born by caesarean section.

    • Postpartum Pelvic Organ Prolapse

    If during a vaginal delivery there is inappropriate management of the delivery such as failure to recognise the size of your baby or incorrect use of forceps and this causes Pelvic Organ Prolapse this may be negligence. This means the uterus (womb), bladder, bowel or the top of the vagina move down into the vaginal canal.  Although not life threatening this can lead to severe bladder and bowel complications, issues during sexual intercourse and considerable life changes. Such injuries may require medical intervention and in some cases surgery.

    • Uterine Rupture

    Uterine rupture during pregnancy or labour is serious and can have devastating issues for both baby and mother. Rapid diagnosis, management or treatment is extremely important. Once diagnosed the baby should be born (caesarean section) and the rupture repaired as quickly as possible. Failure to identify the risk of uterine rupture, failure to diagnose uterine rupture and failure to deliver the baby and treat the rupture hastily can lead to life-threatening and life-changing injuries to the mother potentially leading to hysterectomy, severe post-partum blood loss and even death.  

    • Retained products of conception (RPOC)

    RPOC can occur in a small percentage of normal births, miscarriage and abortion. RPOC is normally recognised and treated. However, failure of a midwife or obstetrician to administer oxytocin correctly, failure to make sure the delivered placenta is complete or failure to perform ultrasound to diagnose RPOC and the removal of the retained products can all lead to retained products in the uterus going unnoticed. A delay in diagnosis and treatment can cause injuries such as pain, life-threatening bleeding, hysterectomy or serious infection.

    • Wrongful Birth

    A wrongful birth means a baby is born who shouldn’t have been born. The two main causes of this are:

    (1) Unplanned conception and unwanted pregnancy due to failed sterilisation or vasectomy.

    (2) Failure to diagnose a disability of the foetus meaning a child is born with a congenital condition of which if the parent had been correctly informed about in pregnancy would have terminated the pregnancy. Examples of this includespina bifida, Down’s Syndrome and congenital heart problems.

    • Psychological Difficulties

    All physical birth injuries can potentially lead to severe emotional and psychological issues in the expectant or new mother and many mothers may experience problems bonding with their baby because of their physical injuries. Psychological problems can be further impacted if injury have been caused by clinical negligence. 85% of mothers who sustain severe injury during child birth say the injuries damaged mother-baby bond with their new-born child. Psychological damage can also be caused by other reasons such as delay in epidural anaesthesia. Psychological injuries following birth (including Postnatal Traumatic Stress Disorder and Post Natal Depression) may mean the mother requires mental health treatment either short-term or long-term.

  • How we can help you claim compensation for an injury whilst pregnant or giving birth

    It can take courage and can initially feel daunting approaching a medical negligence solicitor. This is particularly so when wishing to challenge the treatment and care provided by healthcare professionals who we often hold in high regard and who we place our health and trust in. The medical profession is not selective in who they cause harm to.

    It is important to appreciate that mistakes happen in any situation involving human beings, regardless of how well trained, skilled, experienced and caring they are. Where mistakes are made and harm is caused with regard to patient care there are consequences that may lead a patient wishing to consider instructing a solicitor to act on their behalf to bring legal action.

    More often than not, a patient will not be considering financial compensation once medical negligence has arisen. They do not see it being about money rather that they don’t want it to happen to anybody else. This is entirely understandable. As humans, we trust in the training and expertise of our healthcare professionals and don’t expect harm to be caused. Many patients want lessons to be learned to prevent further harm for others.

    Pursuing a claim against a healthcare professional (public and private) does raise awareness. Pursuing a claim leads to investigation and scrutiny and consideration of existing policies and procedures and to further training. It also allows for a financial settlement to be awarded which places a patient in a better position than they may have otherwise been. Financial compensation enhances the quality of life and where it is not about money, it allows a patient to do good with any settlement they may be awarded.

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