Labour is an emotionally and physically stressful experience. The child is inevitably vulnerable to complications during the birth process and the mother is also at risk of injury.

Obstetricians and midwives should always take steps to prevent injury and there a number of conditions that need to be taken into account during pregnancy and birth. These include:

GESTATIONAL DIABETES

Sometimes called maternal diabetes, gestational diabetes is a temporary form of diabetes that can affect mothers during pregnancy. Whilst there are few obvious symptoms, it should be easily diagnosed by a screening test and is routinely carried out where there is a family history of type 2 diabetes or gestational diabetes. Other risk factors include obesity, pregnancy when older than 35, and previous births where the child has a high birth weight.

Failure to diagnose gestational diabetes can lead to miscarriage, still birth or birth defects. It also increases the chances of the child and mother developing type 2 diabetes, as well as the child being large at birth which can complicate labour itself.

PRE-ECLAMPSIA

A condition that affects the placenta, pre-eclampsia is a very serious condition, with potentially fatal consequences to both mother and child.

Regular testing for high blood pressure at ante-natal appointments can detect pre-eclampsia and urine tests can also help to diagnose the condition which causes high levels of protein in the urine.

Undetected, pre-eclampsia can be dangerous for the baby as it will not receive adequate oxygen and nutrients from the placenta, possibly leading to injury and death. The condition can also disrupt the mother’s blood supply, increasing the risk of strokes, organ failure and severe swelling.

Once diagnosed, pre-eclampsia can be monitored and midwives and doctors will be alert to the possible complications and can take precautions to prevent injury occurring. If symptoms of pre-eclampsia develop into serious problems then early induction of labour or caesarean section can be undertaken.

Failure to diagnose or adequately manage pre-eclampsia often gives rise to claims.

EPISIOTOMY AND TEARS

An episiotomy is a surgical incision made to make the delivery of the child easier and place less stress on the mother’s body. A decision on making an episiotomy is usually taken relatively late on during labour and should be considered when the baby is in distress or the mother is thought to be at additional risk of tearing.

Anyone who has suffered a tear during labour and believes this could have been prevented had an episiotomy been carried out, may have a claim. Injuries caused by a preventable tear are often severe and can have lasting practical and cosmetic affects. Such injuries can also leave a mother more prone to tears during subsequent births, making a caesarean more likely in future.

Other claims will arise when an episiotomy is performed unnecessarily. It is accepted that whilst episiotomies reduce the risk of unmanaged tears where the mother is thought to be at risk of tearing, an episiotomy can also increase the risk of a more serious tear (a third or second degree tear) because the cut tissue is more susceptible to further tearing. An episiotomy should only be carried out when it is necessary, where delivering the baby is difficult because of the size or angle (breech position), or where the mother is thought to be likely to tear.

The clinical negligence team at Geldards has also brought cases on behalf of mothers who have had concerns about poor stitching of tears or episiotomy incisions. Negligent stitching can cause cosmetic problems as well as pain and infection. In some cases, this can lead to the mother having to undergo a procedure to remedy poor stitching. In other cases, the mother is left with ongoing problems.

If you feel that you may have a claim, please contact a member of the clinical negligence team for a free initial consultation.


RELEVANT CASES

CLAIMANT v SUNDERLAND HOSPITAL NHS TRUST

Gauze negligently left in vagina after childbirth, which led to an infection requiring antibiotics. 5 weeks pain and suffering during which time the Claimant had difficulty caring for her newborn baby.

Out of court settlement, damages £3,500.


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