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.