Birth Injury

What is a birth injury?

A birth injury is an injury to a mother or baby that occurs before, during, or shortly after childbirth. Serious birth injuries are rare, but when they occur, they can cause devastating effects that may require a lifetime of treatment. If these injuries were due to the medical malpractice of a doctor, nurse midwife, nurse, or any other healthcare provider, the child and/or their family may be able to bring a lawsuit.

What is a birth injury to a mother?

Separate from their babies, mothers can suffer serious injuries during pregnancy and childbirth. These injuries can include untreated preeclampsia, uterine rupture, infection, complications from a cesarean section, complications from anesthesia, failure to deliver all fetal tissue (called retained products of conception), and uncontrolled bleeding. These may not only cause pain and injury to the mother, but they could also prevent the ability to have future children or increase risks of harm in future pregnancies. In situations where the medical malpractice of a medical provider caused a preventable injury to a mother during pregnancy or childbirth, she and her family may have a claim for medical malpractice.

What causes a birth injury?

Sometimes a birth injury may be due to the natural forces of labor and delivery. However, sometimes they are caused by medical malpractice committed by a doctor, nurse midwife, nurse, or other medical provider. 

Because the labor and delivery process, by its nature, places stress on both the mother and the baby, medical providers must be extremely diligent and careful when tending to the mother and baby. Although there are times when the baby and mother are injured through no fault of a medical provider, there are times when, unfortunately, the medical provider’s failure to provide appropriate medical care causes serious injury. 

Birth injuries can be caused by: 

• Failing to monitor the mother and baby appropriately
• Failing to deliver the baby in a timely manner
• Failing to deliver the baby via cesarean section
• Improper use of medications during labor and delivery
• Improper care during the actual delivery
• Improper resuscitation of the baby at birth
• Improper care post-delivery (in the maternity ward or NICU)

Separately, in some cases, a baby may suffer prematurity-related issues, infection at birth, brain injuries due to a reduction or deprivation of oxygen, and physical deformities and disabilities due to medical negligence. Sometimes these injuries are predictable and, therefore, avoidable if the medical provider acts within the standard of care during a mother’s pregnancy. 

What are the most common birth injuries?

Although there are many types of injuries that babies can unfortunately suffer, two severe injuries that can result from negligence during pregnancy or childbirth include permanent brain injury due to oxygen reduction or deprivation, leading in some cases to cerebral palsy, or injuries to the baby’s arms or shoulders - called a brachial plexus injury or Erb’s palsy. 

What is a birth injury lawsuit?

If a medical provider was negligent, the injured patient may be able to bring a medical malpractice claim against them. 

To prove that a patient’s injuries were due to a medical professional’s medical negligence, the patient must prove that: 

1. The medical provider owed a professional duty to the patient;
2. The medical provider breached that duty (a breach of the standard of care);
3. The patient’s injury was caused by that medical provider’s breach; and
4. The patient suffered damages as a result of that breach.

In Delaware, even before a claim is filed, the injured party needs to retain a qualified medical expert who can support the claim. These experts will evaluate whether the failure to comply with the standard of care (also called a “breach” or “violation” of the standard of care), or the patient’s injuries that resulted, was due to medical negligence. Thus, to pursue a birth injury claim successfully, it is critical to hire attorneys who can retain competent and qualified experts. 

What is birth injury compensation?

A birth injury may cause life-long needs for the child and their family. Those needs may include significant costs for around-the-clock care. The injured party may also be entitled to compensation for emotional distress, lost wages (including lost future earning capacity), and medical expenses for treatment, procedures, and equipment. 

Compensation received from a medical malpractice claim can help the injured party and his or her family pay for future medical treatment to improve the quality of life for the child and their family. This may include future:

• Nursing care
• Physical therapy, occupational therapy, speech therapy
• Medication
• Mobility aids and adaptive equipment
• Surgery
• Special education costs
• Other related expenses

What is the statute of limitations for filing a birth injury claim in Delaware?

A statute of limitations is a law that limits how long a person has to file a lawsuit. In Delaware, in most situations, an injured person has two years from the date of the medical provider’s negligence to file a medical malpractice claim. There are situations where the timeframe may be extended, but those are rare. To make sure your claim is filed timely, it is important to speak with an attorney as soon as possible. 

Why choose Morris James to represent you?

The lawyers of Morris James have been fighting for victims of negligence in Delaware since we opened our doors in 1932. We deal with lawyers and insurance companies so that you can focus on healing. Our birth injury attorneys, who represented healthcare providers for many years in medical malpractice cases, know the strategies used to defend healthcare providers and how to combat them. We will fiercely advocate for our clients, going to trial when necessary, to obtain the financial compensation that you and your family need to regain stability and security after a birth injury.

If you or your child have suffered a birth injury, we may be able to help. Our attorneys at Morris James are available to talk to you about your rights and the options that you have at this difficult time. Contact us online or call into one of our local Morris James offices in Delaware to find out more.

What is cerebral palsy?

Cerebral palsy refers to a group of neurologic disorders that impact a person’s motor skills and cognitive development. It typically presents with stiff muscles (called spasticity), uncontrollable movements (called dyskinesia), and/or poor balance and coordination (called ataxia). The most common form of cerebral palsy is called spastic cerebral palsy, where a person has increased muscle tone, making their muscles and difficult to move. Other types include dyskinetic cerebral palsy, where people cannot control the movement of their hands, arms, feet, legs, mouth, or tongue; ataxic cerebral palsy, where people have issues with balance, coordination, or writing; and mixed cerebral palsy, where people have symptoms of more than one type of cerebral palsy. Unfortunately, a byproduct of a cerebral palsy diagnosis can be significant cognitive delays and impairments.

The severity of a person’s cerebral palsy can range from mild to severe. In a mild case, a person with cerebral palsy may have an awkward walk or mild cognitive delay but may be able to function independently. By contrast, in a severe case, a person may be unable to control his movements, may be bound to a wheelchair, may have profound intellectual disabilities, and may need lifelong care to perform even the most basic tasks. 

What causes cerebral palsy?

Cerebral palsy is caused by the abnormal development of the brain or damage to the developing brain. This typically occurs during pregnancy, during labor and delivery, or after the child’s birth (typically during the first years of the child’s life). A small percentage of cerebral palsy cases occur after birth and are typically associated with an infection or head injury. These cases are called “acquired” cerebral palsy. Most cases of cerebral palsy, however, are congenital (i.e., occurring from birth).

The causes of abnormal development of the brain vary. In some cases, it is unclear why the child developed cerebral palsy. In others, however, the child may have had insufficient blood flow and oxygen to the brain during pregnancy or during labor and delivery, and it can be easier to determine the cause of the child’s cerebral palsy. In these cases, there may be significant warning signs that the baby was not getting adequate blood and oxygen to the brain for a prolonged period of time, and had the medical team delivered the child sooner, the child would not have developed cerebral palsy. If your child was diagnosed with cerebral palsy and the delivery team failed to act in a timely and appropriate manner during labor and delivery, then you may have a medical malpractice claim.

How can cerebral palsy be avoided?

Not all cases of cerebral palsy can be avoided, as some may be due to factors beyond a medical professional’s control. Yet, in some cases, a healthcare provider’s failure to monitor the mother and her baby during pregnancy and labor, and deliver the baby quickly, can cause cerebral palsy. 

A classic warning sign that the child may be at risk for cerebral palsy, or may have already suffered cerebral palsy before birth, is evidence of fetal distress during pregnancy, or during labor and delivery. Signs of fetal distress during pregnancy include:

• Decreased movement by the baby during pregnancy
• Abnormal cramping
• Vaginal bleeding
• Excessive weight gain
• Inadequate weight gain

When a woman goes into labor, there are other signs of fetal distress that must be recognized timely and treated appropriately to avoid the risk of cerebral palsy and other injuries to the baby. Those include:

• Abnormal fetal heart rate
• Abnormal fetal heart rhythm
• Low amniotic fluid levels
• Abnormal biophysical profile (BPP) results
• High maternal blood pressure
• Inappropriate responses of the baby to contractions during labor
• Meconium-stained fluid (thick, greenish-black substance found in the amniotic fluid)

Because of the harm that fetal distress can cause a child, including cerebral palsy, it is important that the medical team recognize these potential signs immediately. Once recognized, the healthcare providers should move to alleviate it and, if it cannot be fixed, promptly deliver the child. If the healthcare team fails to do that, the child can suffer brain damage, including developing cerebral palsy. In that situation, the healthcare team may have committed medical malpractice.

How do I know if my child has cerebral palsy?

Diagnosing cerebral palsy can be difficult, especially at a young age, due to the different types and functional levels of people with cerebral palsy. Other potential signs, depending on the age, include:

• A baby’s head lagging when picked up
• A baby feeling stiff
• A baby feeling floppy
• A baby that seems to overextend his back and neck away from the person holding him or her
• A child’s failure to meet a motor or movement milestone (things like rolling over, crawling, sitting, standing, or walking) 
• A child’s inability to bring his or her hands together or to his or her mouth
• A child who reaches out with only one hand while keeping the other in a fist
• A child who crawls in a lopsided manner by using one hand and one leg while dragging the others
• A child who hops on knees and scoots on his buttocks but does not crawl correctly

Many times, these behaviors are not indicative of cerebral palsy. However, because they may indicate that diagnosis, it is important to have a trained medical professional with experience in treating children with cerebral palsy (typically a pediatric neurologist) as part of the treatment team to help make this diagnosis. 

If my child has cerebral palsy, what does that mean?

Unfortunately, there is no known cure for cerebral palsy. Nonetheless, there is treatment that can help to improve the lives of a person with cerebral palsy. Because early intervention can help to improve the cerebral palsy patient’s life, early diagnosis and early treatment is important. Treatment may include different medicines, medical procedures, equipment, and therapy (usually physical, occupational, and speech therapy). The healthcare team that assesses your child can make appropriate treatment recommendations, depending on the type and severity of cerebral palsy. There are also various governmental resources available to help families with children with cerebral palsy. 

Even with treatment and resources, the impact of a cerebral palsy diagnosis can be profound. The child with cerebral palsy may be dependent on the family or others for all needs, placing a significant burden on the family. Costs for the care, medication and therapy can be significant, but given the demands of a child with cerebral palsy, it can be difficult for a family to earn an income and provide appropriate and necessary care for their child. 

When should I speak with a lawyer? 

If your child has been diagnosed with cerebral palsy, and if you believe that you or your baby were not treated appropriately during your pregnancy or labor and delivery, then you should consider speaking with an attorney. Given the complexity of pregnancy and the labor and delivery process, it can be difficult to determine whether a healthcare provider’s medical malpractice caused the child’s cerebral palsy. Having an experienced medical malpractice lawyer who has handled several cases involving significant birth injuries like cerebral palsy is key to making these determinations, as the lawyer has the tools and knowhow to investigate your case, determine whether the medical team should have delivered your child sooner, and whether earlier delivery would have avoided the diagnosis of cerebral palsy. An experienced birth injury lawyer also knows how to get answers from your healthcare team, and can make them pay fair compensation for your and your child’s injuries.

Why Morris James?

The medical malpractice attorneys at Morris James have handled many complex birth injury cases, including those involving severe cases of cerebral palsy. They are familiar with the issues surrounding cerebral palsy, including the types of care required for the child’s needs, the variety of experts who can support a claim for malpractice, and the hurdles healthcare providers place before families who simply want answers about this devastating condition. Our attorneys know how to fight for your rights and will, if necessary, go to trial to obtain the maximum compensation for your child’s cerebral palsy injury. 

At Morris James, our attorneys have been standing up for victims since we opened our doors in 1932. If you have questions about cerebral palsy, you may find answers in our birth injury FAQs, or you can contact us online or call us at 302.655.2599 to learn more.

Electronic fetal monitoring (“EFM”) is used for most women during labor. EFM allows the medical providers to see how the baby is doing in response to the stresses of labor. It provides important information that the medical team uses to determine many things, including whether the plan for a vaginal delivery is no longer a safe option for the baby. This article discusses EFM, medical malpractice claims involving EFM, and answers common questions family members may have about EFM if their baby suffered a birth injury.

Electronic fetal monitoring (“EFM”) is used for most women during labor. EFM allows the medical providers to see how the baby is doing in response to the stresses of labor. It provides important information that the medical team uses to determine many things, including whether the plan for a vaginal delivery is no longer a safe option for the baby. This article discusses EFM, medical malpractice claims involving EFM, and answers common questions family members may have about EFM if their baby suffered a birth injury.

What is Electronic Fetal Monitoring?

EFM can monitor the baby’s health during labor by continuously recording the fetal heart rate. The fetal heart rate pattern is important to assess because it can help determine if the fetus is getting enough oxygen during labor and delivery. When a baby is deprived of sufficient oxygen, the baby can suffer injuries to his or her organs, including the brain. Brain injuries occurring during labor and delivery can be permanent, and significantly alter that child’s life. Cerebral palsy, for example, is a motor disability that a child can develop if they did not get enough oxygen during labor and delivery. 

EFM not only monitors the baby’s fetal heart rate. It also monitors and traces the mother’s uterine activity, continuously showing the mother’s contractions, including how long they last and how strong they are. The mother’s contraction pattern is important information that the medical providers need to watch closely. When a mother has a contraction, it can briefly disrupt blood flow to the baby, decreasing the amount of oxygen they receive. While some disruption of the blood flow to the baby is normal, sometimes a contraction can cause a prolonged disruption of blood and oxygen to the baby. The medical providers should also closely monitor the mother’s contraction pattern to make sure the contractions are frequent and strong enough to deliver the baby. If they are not, the mother may need medications to augment labor so the baby can be delivered safely. 

For these reasons, the medical providers are required to closely watch how the baby’s heart rate responds to the mother’s contractions. If the baby is not responding well to the mother’s contractions, or the labor more generally, the medical providers must take action to protect the baby, which may include abandoning the plan for a vaginal delivery in favor of a Cesarean section. If the medical providers do not act quickly, or fail to appreciate the information provided by EFM, they may cause serious injuries to the mother and/or baby. In that case, the medical providers may also be guilty of medical malpractice. 

Did A Failure to Monitor or Use EFM Appropriately Cause A Birth Injury?

Unfortunately, there are situations where the medical team fails to appropriately use or interpret EFM. When this occurs, the medical providers may be guilty of medical malpractice, and can be held accountable for the injuries their negligence causes. There are many examples of cases where medical providers commit malpractice related to EFM. A few examples are discussed here. 

Malpractice can occur if the medical provider implements EFM but fails to check the monitoring frequently enough to ensure that the baby can tolerate labor. The frequency with which a medical provider must review the EFM to assess the baby’s well-being depends on the situation. But more frequent reviews are required if the mother is high-risk or given medication to induce or augment labor. More frequent reviews are also required once the mother enters the second stage of labor and begins pushing. Typically, the medical providers are able to assess the EFM strips, showing both fetal heart rate and uterine activity, in the labor and delivery room as well as elsewhere in the hospital. Thus, medical providers should have easy access to this information and should have no excuse for not watching it closely.

Malpractice can also occur if the medical providers fail to accurately interpret the EFM. EFM is not easy to interpret, but medical providers are trained how to do so, and are required to interpret EFM accurately so that the mother and baby do not suffer a preventable injury. In some cases, the medical providers fail to appreciate that the baby is not responding appropriately to the stresses of labor and allow the labor to progress. If the EFM shows that the baby is not responding appropriately, but the medical team allows labor to progress, the baby can suffer injuries. 

Another example of medical malpractice related to EFM is where the medical providers accurately interpret the fetal monitoring strip, but fail to appropriately act in response to the information provided by EFM. There are certain patterns medical providers are trained to look for on the EFM, and when those patterns are present, a plan needs to be put in place to respond quickly and appropriately. The response may be providing the mother IV fluids or supplemental oxygen, or repositioning the mother. If those measures do not result in a better fetal heart rate pattern, or if they indicate that the baby is not otherwise tolerating labor, the medical providers need to quickly recognize it and may need to plan for an emergency Cesarean delivery. When medical providers fail to institute these measures in response to worrisome findings on EFM, they may commit medical malpractice. The medical providers may also commit malpractice if they delay intervention, or mistakenly believe that the information provided by EFM suggests that the baby is tolerating the stresses of labor when, in fact, the baby is not and suffers an injury. 

If You or Your Child Suffered A Birth Injury, What Does That Mean?

If you or your child suffered an injury at birth, you should certainly discuss the next steps with the appropriate medical providers to ensure that you and your child are evaluated and treated by the appropriate specialist. Some birth injuries may only be temporary, but others may be permanent and require life-long medical care.

Birth injuries caused by the failure to appropriately use or interpret EFM can cause life-long difficulties with everyday activities, requiring modifications to your or your child’s schooling, job responsibilities, and leisure activities. It may also require ongoing therapy to prevent the injury’s impact from worsening over time. Future activity modifications and therapy over the course of a lifetime can be very expensive. These injuries can also cause physical disfigurement and significant emotional harm to a child or parent, as these injuries may make the child feel different, and impact his or her social wellbeing. 

If you or your baby suffered a birth injury due to medical malpractice, the physician and delivery team can be held responsible for the birth injury and all its consequences, including the costs of future medical care. It is very important to retain a lawyer who is experienced in handling birth injury cases and understands how to successfully hold the physician accountable. The medical malpractice attorneys at Morris James are experienced in birth injury cases, and can assist you and your child in presenting the strongest claim possible.

When Should I Speak With A Lawyer?

If you or your child has suffered a birth injury, and if you believe that you or your baby were not monitored appropriately during your pregnancy or labor and delivery, then you should consider speaking with an attorney. Given the complexity of pregnancy and the labor and delivery process, it can be difficult to determine whether a healthcare provider’s medical malpractice caused injuries to you or your child. Hiring a medical malpractice lawyer who has experience handling cases involving EFM and birth injuries is key to making these determinations, as the lawyer has the tools and knowhow to investigate your case to determine whether the medical team committed medical malpractice, and how to prove such a claim in the court of law. An experienced birth injury lawyer also knows how to get answers from your healthcare team, and can make them pay fair compensation for your and your child’s injuries.

Why Morris James?

The medical malpractice attorneys at Morris James have handled many complex birth injury cases, including those involving EFM. They are familiar with the issues in these cases, including the interpretation of an EFM strip, how a medical provider should respond to the findings on the EFM strip, the types of experts who can successfully support a claim for malpractice, and the hurdles healthcare providers place before families who simply want answers. Our attorneys know how to fight for your rights and will, if necessary, go to trial to obtain the maximum compensation for the injury you or your child suffered. 

At Morris James, our attorneys have been standing up for victims since we opened our doors in 1932. If you have questions about electronic fetal monitoring or any other birth injury, you may find answers in our birth injury FAQs, or you can contact us online or call us at 302.655.2599 to learn more.

What is considered medical malpractice?

Medical malpractice, also known as medical negligence, occurs when a hospital, doctor, or other health care professional fails to comply with the standard of care and causes an injury to a patient. The standard of care refers to the requirement that a medical professional act as a reasonably prudent and diligent medical professional.

How do you prove medical negligence?

Not all failures to comply with the standard of care (also called a “breach” or “violation” of the standard of care) equate with medical negligence. Nor do all injuries to patients mean that a medical professional breached the standard of care. Rather, to prove that a patient’s injuries or harms were due to a healthcare professional’s medical negligence, the person must prove that: 

1. The healthcare provider owed a professional duty to the patient;
2. The healthcare provider breached that duty (a breach of the standard of care);
3. The patient’s injury was caused by that healthcare provider’s breach; and
4. The patient suffered damages as a result of that breach.

To prove medical malpractice, the injured party must present medical expert testimony that there was a standard of care breach that caused damages.  Even before a claim is filed, the injured party needs to retain a qualified medical expert who can support the claim. Thus, to pursue a medical negligence claim successfully, it is critical to hire attorneys who can retain competent and qualified experts. 

What is the statute of limitations for medical malpractice in Delaware?

A statute of limitations is a law that limits how long a person has to file a lawsuit. In Delaware, in most situations, an injured person has two years from the date of the healthcare provider’s negligence to file a medical malpractice claim. There are situations where the timeframe may be extended, but those are rare. To make sure your claim is filed timely, it is important to speak with an attorney as soon as possible. 

Will my case go to trial? 

Sometimes the injured party and the healthcare providers are able to resolve their matter before trial. If, however, the defendant healthcare providers refuse to pay a fair amount, our team recommends that we go to a trial to receive fair compensation. The attorneys at Morris James have tried many cases to verdict and know how to fight for their client’s right to fair compensation. 

How is medical malpractice pain and suffering calculated?

Although every state is slightly different, many states ask a jury to evaluate an injured party’s pain and suffering by considering a number of factors. Those include the injured party’s physical pain caused by the injury itself, any discomfort resulting from necessary medical treatment, and mental anguish and other emotional stressors from the injury. A jury can also consider disfigurement and loss of ability to enjoy life’s pleasures. The jury may also consider the costs of any medical care incurred, the costs associated with future treatment that is needed as a result of the injuries sustained, and lost earnings due the inability to work from the injuries. 

Because every case is variable, awards can vary widely even in similar cases. The medical malpractice attorneys at Morris James are keenly aware of how juries calculate damages awards given their experience and use this knowledge to leverage their clients’ cases to obtain the best possible outcomes, whether through settlement or at trial. 

What are the most common medical malpractice claims?

The attorneys at Morris James LLP have litigated almost every type of medical malpractice claim. Some common types of malpractice claims include:

Pregnancy care and labor & delivery management - The birth of one’s child is one of the most exciting and wonderful experiences in a person’s life. Unfortunately, this event can turn horrific if the medical providers involved do not act appropriately to monitor the mother and baby. If the healthcare providers fail to treat the mother or child appropriately during her pregnancy or her labor and delivery, that can lead to catastrophic injuries to both the mother, father and baby. Some of these injuries include physical injuries to the baby’s head, arms, or shoulders and can include devastating neurologic injuries like brain bleeds and cerebral palsy - injuries that a patient and family will need to face for the entirety of their lives. 

Hospital negligence - Patients go to a hospital for all types of care, including emergency room care, surgeries, births, and other issues. While at a hospital, patients can be treated by numerous healthcare providers, including doctors, physician assistants, nurse practitioners, and nurses. When these providers breach the standard of care and harm a patient, regardless of the type of care, the hospital may be responsible for those injuries. 

Failure to diagnose a medical condition - If the healthcare provider acted negligently in failing to identify, diagnose and treat the medical condition, and if that delay caused harm, the treating healthcare provider might be liable for medical malpractice. In certain cases, such as cancer, the medical condition leading to harm can be severe.  

Failure to follow-up - There are times when a patient expects a healthcare provider like a doctor to follow-up on a test, a visit, or a study. This typically happens after a patient has blood drawn for lab tests, has a biopsy performed, has an imaging study like an x-ray or other scan, or has an ongoing medical condition. If the healthcare provider doesn’t follow-up when he or she is supposed to do so, and if that failure to follow-up leads to a delay in a medical diagnosis, it can cause harm to the patient. In that situation, the failure to follow-up may be a basis for a medical malpractice claim. 

Failure to monitor - Oftentimes after a patient has a medical procedure, the patient is admitted to the hospital or another medical facility so that the medical staff, including doctors and nurses, can monitor the patient to make sure that there are no new problems that develop. Sometimes, that monitoring is done at the patient’s home by trained medical staff. If the medical providers caring for the patient do not monitor the patient correctly, they can sometimes miss important medical issues, and that can lead to harm. If the medical providers did not monitor the patient correctly, and this failure caused harm, the patient or the patient’s family may have a potential medical malpractice claim. 

Surgical errors - Despite the technological advances and techniques that surgeons have at their disposal, there may still be surgical errors. Sometimes, those are expected, but other times they may be due to the surgeon making unreasonable errors. If a surgeon makes an unreasonable error that causes harm, that can be a basis of medical malpractice. Some examples of surgical errors that might be malpractice include puncturing internal organs, injuring blood vessels, operating on the wrong body part, or leaving surgical instruments inside the body. 

Prescription errors - Healthcare providers may make mistakes with medications for patients. These errors include a doctor or nurse practitioner writing an incorrect dosage on a prescription, issuing a prescription that should never have been given under the circumstances, a nurse administering an incorrect amount of a medication, or medical equipment giving the patient the wrong dose of a medication. When that medical error causes harm, that may be a basis for a medical malpractice claim. 

Why choose Morris James to represent you?

The lawyers of Morris James have been fighting for victims of negligence in Delaware since we opened our doors in 1932. We deal with lawyers and insurance companies so that you can focus on healing. Our medical malpractice attorneys, who represented healthcare providers for many years in medical malpractice cases, know the strategies used to defend healthcare providers and how to combat them. We will fiercely advocate for our clients, going to trial when necessary, to obtain the financial compensation that you need to regain stability and security after your injury.

If you or a loved one has suffered an injury due to a mistake by a healthcare professional, we may be able to help. Our attorneys at Morris James are available to talk to you about your rights and the options that you have at this difficult time. Contact us online or call into one of our local Morris James offices in Delaware to find out more.

Before a woman is about to deliver her baby, she will enter into a process called labor. Labor refers to the period before delivery when the mother experiences a series of continuous and progressive contractions of the uterus. This causes the cervix to open (or dilate) and to thin (or efface). These changes to the cervix allow the baby to move through the birth canal, culminating in delivery. 

Prolonged labor, also known as a failure to progress, occurs when a woman’s labor lasts an atypical amount of time. Although there are different definitions for what constitutes prolonged labor, for first-time mothers, labor has historically been considered prolonged if it lasts for approximately 20 hours or more. For women who have given birth before, labor has historically been considered prolonged if it lasts 14 hours or more. Prolonged labor can be a warning sign that the mother or baby has been injured, or an indication to change the delivery plan. Sometimes, prolonged labor can cause stress on the baby, leading to serious injuries. Thus, a healthcare provider needs to carefully monitor the mother’s labor progress. When healthcare providers fail to carefully monitor labor progress, or appreciate the risks of a prolonged labor, they may commit medical malpractice. 

What causes prolonged labor?

To understand prolonged labor, it is important to understand the different stages of labor. 

When a mother is in the first stage of labor, there are two phases: the latent phase and the active phase. During the latent phase, contractions typically become more frequent and stronger. During this process, the cervix begins to open and thin out. The second phase of the first stage of labor (also called the active phase) occurs when the cervix opens from 4 to 7 centimeters. During this time, contractions become longer, stronger, and more frequent. 

During the second stage of labor, a woman’s cervix is completely open and the mother typically begins to push the baby for delivery. Typically, the second stage is shorter than the first stage and may take between 30 minutes and three hours (depending on a number of factors, including the number of prior pregnancies).

During the third and final stage of labor, a mother will deliver the placenta (the organ that nourishes the baby during pregnancy). This stage typically lasts just a few minutes. 

Prolonged labor typically occurs in the first or second stage of labor, and it can have a number of different causes. Generally speaking, prolonged labor may occur during any phase of labor when: 

• A mother’s contractions are weak
• The baby is in the incorrect position
• Certain medications act to delay labor
• The baby is too large to pass through the birth canal
• The mother’s pelvis is too small to allow the baby to be delivered
• A mother is significantly stressed, exhausted, or anxious

In those situations, the healthcare providers need to recognize the issue and treat the mother and baby appropriately so that the baby can be delivered safely. 

What should be done with prolonged labor?

When a woman’s labor is prolonged, the healthcare providers should evaluate the potential causes and treat those in a timely manner to protect the mother and baby. That may require that the healthcare team move to prompt delivery to avoid harm to the mother and baby. If the healthcare team fails to recognize a prolonged labor, the mother or baby can suffer injuries.

Healthcare providers can use different methods to attempt to expedite labor and delivery. Those include:

• Allowing the mother to rest for a period
• Encouraging movement like walking or changing positions 
• Administering prostaglandin hormone or oxytocin (Pitocin) to stimulate contractions
• Rupturing a woman’s membranes artificially (i.e., causing a woman’s “water to break”)

If one or more of these interventions is attempted, the healthcare team must monitor the mother and her baby continuously. That way, the healthcare providers can make sure that the baby and the mother remain safe. If there are any potential warning signs that the baby or mother cannot tolerate ongoing labor, the healthcare team must recognize that, and change the delivery plan to expedite the baby’s delivery. That may require the healthcare providers to proceed with a C-section to minimize the risk of injury to the mother and baby. A medical provider’s failure to monitor and assess delivery options at this stage could constitute medical malpractice.

In situations where a mother is experiencing prolonged labor, the healthcare providers need to monitor the mother and baby carefully. It is important for the healthcare providers to monitor the mother’s contractions (both in frequency and strength), the mother’s vital signs, and the baby’s heart rate and responses to labor. When prolonged labor persists despite interventions, the health of the mother or baby may be at risk. A failure to monitor when indicated can cause significant injuries to the mother and her baby and may be evidence of medical malpractice. 

What injuries can be caused by a prolonged labor?

Prolonged labor increases the risk of certain injuries to the mother, including:

• Postpartum hemorrhaging (or bleeding following childbirth)
• Obstetric trauma (injuries to the mother)
• Infections

Prolonged labor also increases the risk of complications for the baby, including: 

• Admission to the neonatal intensive care unit (NICU) 
• Low heart rates
• Low muscle tone
• Decreased reflexes
• Difficulty breathing
• Blue skin color

These are potential signs of decreased blood flow and oxygen to the baby’s brain and vital organ systems. If these persist long enough during a prolonged labor, a baby can suffer a brain injury that can cause significant motor and cognitive delays or even death. Click here to read more about birth injuries a baby can suffer when medical providers commit medical malpractice.

One type of brain injury that a baby can suffer as a result of prolonged labor is cerebral palsy, or CP, which is a neurological condition caused by a lack of oxygen and blood flow to the brain. If a child has CP, the child can develop impairments in motor skills, muscle tone, and movement. The child may also have learning disabilities, cognitive impairments, issues with speech, lung issues, low bone density, and limited vision or hearing. Unfortunately, while medical providers can offer treatments for CP, there is no known cure for it. When a child has CP, the child may have to live with lifelong complications. 

Given the severity of this condition, it is crucial that the delivery team monitor the mother and her baby during delivery carefully so that, if there is a prolonged labor, the team can intervene and deliver the baby timely and safely. If the healthcare providers fail to recognize and intervene appropriately to protect the health and safety of the mother and baby, and if they are injured, the medical providers may have committed medical malpractice. 

When should I speak with a lawyer? 

The delivery of a child should be a wonderful experience. But, when a woman has a prolonged labor, and when she or her baby are injured, it can be emotionally traumatizing, and the family may now face significant medical costs associated with care and treatment of the injured child. 

If you think that the healthcare team that treated you and your baby allowed your labor to progress too long, and if you think that caused an injury to you or your child, you should consider speaking to an attorney to determine whether you have a claim for medical malpractice. An experienced medical malpractice lawyer that has handled cases involving birth injuries can investigate your case, work with experts to support your claim, and fight to get you and your family answers and compensation to cover all expenses and costs.

Why Morris James?

The medical malpractice attorneys at Morris James have handled many complex birth injury cases, including those involving prolonged labor. Before advocating for the injured, our attorneys defended healthcare providers who delivered babies so we know how those medical providers defend their care when a baby is injured after a prolonged labor. Our attorneys can anticipate the tactics used to minimize compensation to injured victims and fight for our clients to obtain answers and the full compensation to which they are entitled. 

At Morris James, our attorneys have been standing up for victims since we opened our doors in 1932. If you have questions about a birth injury, you may find answers in our birth injury FAQs, or you can contact us online or call us at 302.655.2599 to learn more.

Shoulder dystocia is a common cause of birth injuries. This article discusses medical malpractice claims involving shoulder dystocia, and answers common questions patients and their family members may have about shoulder dystocia, and the birth injuries it can cause.

What is shoulder dystocia?

During a vaginal delivery, the baby’s head emerges, and the physician or nurse midwife will use his or her hands to gently pull the baby’s head to deliver the body. If the medical provider’s pull or pulls do not result in delivery of the baby’s shoulders because one of the shoulders is stuck on the mother’s pubic bone, a quick diagnosis of shoulder dystocia should be made. If a medical provider fails to diagnose shoulder dystocia, or makes the diagnosis too late, and if that results in injury to the baby, the medical provider may have committed medical malpractice. 

Once the diagnosis of shoulder dystocia is made, the medical provider must act quickly to address this emergency to prevent severe birth injuries to the mother and baby. Obstetricians and other medical providers who deliver babies are trained to respond to a shoulder dystocia by immediately obtaining assistance from other staff, so that they can rapidly employ maneuvers to dislodge the stuck shoulder and deliver the baby safely. If the medical provider delays a request for assistance, or fails to employ maneuvers to deliver the baby, the medical provider may be guilty of medical malpractice and held responsible for any injuries caused by their negligence. Medical providers can also be held responsible for medical negligence if they fail to utilize appropriate maneuvers to deliver the baby safely.

Which birth injuries are caused by shoulder dystocia?

Shoulder dystocia is associated with an increased risk of birth injury to both the mother and baby. Some of the risks to the mother exist because medical providers may need to make a laceration (called an episiotomy) to dislodge the baby’s stuck shoulders. The laceration is made at the opening of the mother’s vagina, and it increases the risk of significant bleeding and nerve injury. If a larger laceration is required to deliver the baby, then it may cause injury to the mother’s sphincter. Other maneuvers used to address a shoulder dystocia can also increase the risk that the mother will suffer a bladder injury, uterine rupture, or urethral injury. 

Shoulder dystocia also increases the risk of serious birth injuries to the baby. The most common birth injury for a baby to suffer due to shoulder dystocia is a brachial plexus injury. Briefly, the brachial plexus is a bundle of nerves that start in your neck and extend through your shoulders and down to your fingers. When a medical provider attempts to dislodge the baby’s shoulder from under the mother’s pubic bone, the provider may pull too hard on the arm or shoulder, stretching the brachial plexus nerves in the neck, which can result in injury to the nerves and loss of movement and sensation in the shoulder, arm or fingers. Brachial plexus injuries can be severe and permanent. If the medical provider causes a brachial plexus injury by pulling too hard on the baby, he or she may have committed medical malpractice and can be held responsible for the injuries they caused.

Shoulder dystocia also increases the risk the baby will suffer a severe brain injury at birth. Cerebral palsy is a type of brain injury that can result from medical malpractice during birth. The risk of brain injury increases with shoulder dystocia because, while the baby is stuck in the birth canal, the umbilical cord may be positioned or compressed in such a way that it stops providing the baby oxygen. If the baby is deprived of oxygen, he or she may suffer injury to their organs, including the brain. Brain injuries occurring near the time of birth can be severe, resulting in a number of permanent neurologic problems, including loss of muscle movement, and problems with speech, swallowing, behavior, and cognition. In some cases, a birth-related brain injury can result in the baby’s death.

What causes shoulder dystocia?

There are certain factors, specific to the mom and baby, that may increase the risk of shoulder dystocia. Common factors that increase the risk of shoulder dystocia and that are specific to the mother include a prior delivery complicated by shoulder dystocia, and maternal diabetes. If either of these factors are present, the mother’s prenatal providers and delivery team should be made aware of these factors, evaluate the risk of shoulder dystocia, and develop a plan to either prevent a shoulder dystocia or immediately address it if it occurs. 

A larger fetus (called fetal macrosomia) is one of the main factors that increases the risk of shoulder dystocia. In this situation, the baby may simply be too large to get through the birth canal to be delivered, and that increases the risk that the baby’s shoulder will get stuck on the mother’s pubic bone. Because a larger fetus increases the risk of an emergency during delivery, it is very important that the medical providers who are responsible for your prenatal care during pregnancy assess your baby’s weight and the diameter of the head and abdomen to assess whether the baby is too big to safely deliver vaginally. These assessments should also be made when you present for delivery at the hospital, so that an appropriate delivery plan can be made. If your medical team fails to appropriately assess your baby’s size, and your baby develops a shoulder dystocia, they may be guilty of medical malpractice and responsible for any injuries that result.

Did medical malpractice cause shoulder dystocia or a related birth injury?

Unfortunately, medical malpractice can cause a patient to unnecessarily encounter shoulder dystocia or a birth injury related to shoulder dystocia. There are different types of medical malpractice claims involving shoulder dystocia. One is a medical provider’s failure to appreciate the risk of shoulder dystocia. That failure can occur during prenatal care or delivery. During either prenatal care or delivery, the medical provider may commit medical malpractice by failing to appropriately assess the size of the baby, or by failing to appreciate the risk that the baby’s size may cause a shoulder dystocia. As discussed above, shoulder dystocia increases the risk of serious birth injuries to the mother and baby. Therefore, it is very important that medical providers consider the risk of shoulder dystocia so that they can appropriately advise the patient of the risks of proceeding with a vaginal delivery and, in some cases, advise the patient that a Cesarean delivery is a safer option for the mother and/or baby.

Another type of medical malpractice claim related to shoulder dystocia is a medical provider’s failure to timely diagnose shoulder dystocia during delivery. If the diagnosis is not made, or it is made too late, the baby may lose oxygen, resulting in a brain injury. A failure to timely diagnose shoulder dystocia may also cause the delivering medical provider to apply too much force while the shoulder remains stuck, stretching the brachial plexus nerves beyond their limit, resulting in a brachial plexus injury.

Finally, another common claim relates to a medical provider’s failure to use appropriate maneuvers to deliver the baby after the shoulder dystocia has been diagnosed. A medical provider’s use of too much force, moving the baby’s head too far away from the shoulder, or using too many maneuvers before deciding a different form of delivery is needed, can result in injuries to the mother and baby. When this happens, the medical provider may be guilty of medical malpractice, and can be held responsible for birth injuries to the mother or baby.

If you or your child suffered a shoulder dystocia-related birth injury, what does that mean?

If you or your child suffered an injury at birth, and a shoulder dystocia diagnosis was also made, you should certainly discuss the next steps with the appropriate medical providers to ensure that you and your child are evaluated and treated by the appropriate specialist. Some shoulder dystocia-related birth injuries may only be temporary, but others may be permanent and require life-long medical care.

Birth injuries related to shoulder dystocia can cause life-long difficulties with everyday activities, requiring modifications to your or your child’s schooling, job-responsibilities, and leisurely activities. It may also require ongoing therapy to prevent the injury’s impact from worsening over time. Future activity modifications and therapy over the course of a lifetime can be very expensive. These injuries can also cause physical disfigurement and significant emotional harm to a child or parent, as these injuries may make the child feel different and impact his or her social wellbeing. 

If you or your baby suffered a birth injury due to medical malpractice, the physician can be held responsible for the birth injury and all its consequences, including the costs of future medical care. It is very important to retain a lawyer who is experienced in handling birth injury cases and understands who to successfully hold the physician accountable. The medical malpractice attorneys at Morris James are experienced in birth injury cases, and can assist you and your child in presenting the strongest claim possible.

When should I speak with a lawyer?

If you or your child has suffered an injury related to shoulder dystocia, and if you believe that you or your baby were not treated appropriately during your pregnancy or labor and delivery, then you should consider speaking with an attorney. Given the complexity of pregnancy and the labor and delivery process, it can be difficult to determine whether a healthcare provider’s medical malpractice caused injuries to you or your child. Hiring a medical malpractice lawyer who has handled several cases involving shoulder dystocia is key to making these determinations, as the lawyer has the tools and knowhow to investigate your case to determine whether the medical team committed medical malpractice, and how to prove such a claim in the court of law. An experienced birth injury lawyer also knows how to get answers from your healthcare team, and can make them pay fair compensation for your and your child’s injuries.

Why Morris James?

The medical malpractice attorneys at Morris James have handled many complex birth injury cases, including those involving shoulder dystocia. They are familiar with the issues in these cases, including what a provider could have done to prevent a shoulder dystocia or shoulder dystocia-related injuries, the types of experts who can successfully support a claim for malpractice, and the hurdles healthcare providers place before families who simply want answers. Our attorneys know how to fight for your rights and will, if necessary, go to trial to obtain the maximum compensation for the injury you or your child suffered. 

At Morris James, our attorneys have been standing up for victims since we opened our doors in 1932. If you have questions about shoulder dystocia or any other birth injury, you may find answers in our birth injury FAQs, or you can contact us online or call us at 302.655.2599 to learn more.