Turned down for a C section & baby dies

[August]

So you are saying that it was this woman's fault that her baby died because she either didn't have a birth plan or her birth plan didn't address instrumental delivery and that she consented to a procedure that involved risks. So oops, too bad, so sad -- you've got a dead baby now because you "made the wrong decision"?

No, I'm saying that you don't get to sue people because you don't like the outcome of your own decision. Sue him because he was inexperienced with forceps, or because he told her it was indicated when it wasn't (ie, molded head), sue the hospital because he had been working too many hours, or if he dud a procedure without consent, but you can't be an active participant and then turn around and claim the whole thing was forced on you against your will.

[August]

I remember reading an article about the rise of c-sections, and from what I recall it said that even today complications and recovery time with forceps tend to be lower BUT that complications with forceps, when they occur, are much more likely to be devastating and that, of course, it is much harder to teach doctors to use forceps than to teach other methods, such as, of course, c-sections.

But I don't know how accurate that is.

Did it account for low/med/high forceps? IIRC the biggest drop has been in the ones where the baby's not even engaged. But that's from memory from research when I was pg the first time, many years ago.

[scc12]

idk,I haven't had any problems from forceps use,and that was almost 24 years ago.I think she was lying low though.The Dr said he wasn't going to use them unless her head had reached a certain point.

[lascuba]

No, I'm saying that you don't get to sue people because you don't like the outcome of your own decision. Sue him because he was inexperienced with forceps, or because he told her it was indicated when it wasn't (ie, molded head), sue the hospital because he had been working too many hours, or if he dud a procedure without consent, but you can't be an active participant and then turn around and claim the whole thing was forced on you against your will.

What does being an "active participant" mean in this case? I know people love to believe they're educated on whatever topic because they have an internet connection, but this woman is not an OB. It is not her responsibility to learn in 9 months what OBs learn in 12+ years. Was she supposed to predict the use of forceps and put them as no-no on her birth plan? Is that why she shouldn't sue? Because it doesn't work that way.

[Belle0000]

This story sends chills down my spine. I had my first child 2 weeks ago, and the doctor ended up using forceps. Luckily, everything went ok with the forceps and I ended up with a healthy 9lb 4oz baby. I was never asked at any point if I was ok with forceps--or an episiotomy for that matter, and I tore more after the cut was made and ended up with a 4th degree tear. I didn't think forceps or episiotomies were very common anymore, so I didn't think to address either one ahead of time (and for my OB, they weren't common--she has only done one episiotomy in her career, but her partner was the one who delivered). The L&D nurses said afterwards that they were surprised that the doctor didn't opt for a c-section, and that they had started to prep for one.

I ended up losing a lot of blood and had to have a transfusion. The doctor I saw after delivery described it as a "traumatic delivery" that was "basically like a c-section in a more inconvenient place".

We want to have more children, but I will have a lot of questions for my OB at my 6 week check up. The blood loss and transfusion made for an awful recovery and I'm just now starting to feel normal again. I had hoped to avoid a c-section, but in hindsight, I think I would have preferred it over the experience I had.

[galaxy]

What does being an "active participant" mean in this case? I know people love to believe they're educated on whatever topic because they have an internet connection, but this woman is not an OB. It is not her responsibility to learn in 9 months what OBs learn in 12+ years. Was she supposed to predict the use of forceps and put them as no-no on her birth plan? Is that why she shouldn't sue? Because it doesn't work that way.

SERIOUSLY. I cannot believe anyone is at all blaming the mother in this case. She asked for a C-section and the hospital/doctor wouldn't give her one, and her baby died as a result. Seems like a good enough reason to sue IMO. You shouldn't have to have a written birth plan to avoid your baby dying during birth and even if she did have a written birth plan it sounds like the hospital would have disregarded it anyway.

[August]

What does being an "active participant" mean in this case? I know people love to believe they're educated on whatever topic because they have an internet connection, but this woman is not an OB. It is not her responsibility to learn in 9 months what OBs learn in 12+ years. Was she supposed to predict the use of forceps and put them as no-no on her birth plan? Is that why she shouldn't sue? Because it doesn't work that way.

Well, that's what she's saying she did, not me. She's saying she should have had a c-section. But birth isn't something where you have a meeting with your OB in week 38 and what you decide then is what happens. There would have been many points in the labor to make decisions, including the one where they say "OK, baby's not coming down, I want to use forceps to give her a bit of help, but we're looking at a c-section if this doesn't work". And that's where someone who (as she's claiming she was) is fixated on a c-section says "please, just give me the c-section".

[apple1]

But birth isn't something where you have a meeting with your OB in week 38 and what you decide then is what happens.

The above statement is 100% true. All kinds of unpredicted things can happen once labor and delivery is happening.

And given that, I violently disagree with placing blame on a "birth plan" or lack thereof.

How about this: EVERY woman delivering with the help of a professional (OB or midwife, hospital or birthing center, whatever) should know that yes, there is a birth plan. It's called healthy-mom-healthy-baby. All other facets of any birth plan take 2nd place to the health-mom-healthy-baby plan. And if the professionals (who in truth, run the show) decide that some facet of the laboring mother's birth plan does not allow the healthy-mom-healthy-baby outcome, they can override the laboring mother's birth plan.

Any blame that may exist in this case has nothing to do with birth plan. And wrong decisions in this case are the fault of the physician who made the wrong decisions.

[lascuba]

The above statement is 100% true. All kinds of unpredicted things can happen once labor and delivery is happening.

And given that, I violently disagree with placing blame on a "birth plan" or lack thereof.

How about this: EVERY woman delivering with the help of a professional (OB or midwife, hospital or birthing center, whatever) should know that yes, there is a birth plan. It's called healthy-mom-healthy-baby. All other facets of any birth plan take 2nd place to the health-mom-healthy-baby plan. And if the professionals (who in truth, run the show) decide that some facet of the laboring mother's birth plan does not allow the healthy-mom-healthy-baby outcome, they can override the laboring mother's birth plan.

Any blame that may exist in this case has nothing to do with birth plan. And wrong decisions in this case are the fault of the physician who made the wrong decisions.

Exactly. Any time a baby ends up injured or dead because of a doctor's actions, that doctor (and maybe the hospital if if he strictly following hospital policy) is solely responsible. This wasn't a situation where the baby died because the mother was steeped in natural birth woo and refused to consent to a c-section-- just the opposite, actually. A C-section would have saved that baby; the mother asked for a c-section; the doctor refused for who knows what reasons, and instead chose to use a method he clearly did not have adequate training for. There's no ambiguity here.

[NotALoserLikeYou]

The above statement is 100% true. All kinds of unpredicted things can happen once labor and delivery is happening.

And given that, I violently disagree with placing blame on a "birth plan" or lack thereof.

How about this: EVERY woman delivering with the help of a professional (OB or midwife, hospital or birthing center, whatever) should know that yes, there is a birth plan. It's called healthy-mom-healthy-baby. All other facets of any birth plan take 2nd place to the health-mom-healthy-baby plan. And if the professionals (who in truth, run the show) decide that some facet of the laboring mother's birth plan does not allow the healthy-mom-healthy-baby outcome, they can override the laboring mother's birth plan.

Any blame that may exist in this case has nothing to do with birth plan. And wrong decisions in this case are the fault of the physician who made the wrong decisions.

Yes to your last paragraph but no to the previous one. I don't want my healthcare provider to have the power to override all my decisions. I should be able to refuse meds, surgery, interventions, IV antibiotics, episiotomies, etc. Hospitals have gotten court orders to do a csection because they predict the baby will be too big. The mom went to another hospital and had a natural delivery. I do not agree that they "run the show." It's still my body.

The hospital probably will use the defense that the mom contributed to the negligence that occurred here but they will lose. What happened here is disgusting. I cant even imagine enduring that.

[argypargy]

Honestly, it doesn't matter if she requested a c-section or not at this point in time. The doctor made the wrong decision and he is liable for the death of that child. The right decision was to do the c-section. If you have to brace yourself to pull the baby out with forceps, then it's a bad idea. This is malpractice through and through.

Also, a birth plan is just that...a plan. Sometimes things don't go to plan. It's not a contract that the patient and doctor sign, because, at the end of the day, the goal is healthy baby, healthy mother no matter the means to get there.

[2xx1xy1JD]

This is a tragic case, but there is no way that we can conclude that a doctor deserves to lose their license based on a newspaper article.

Hindsight is 20/20. Knowing the outcome, of course you'd say now that it would have been better to perform a c-section from the get-go.

Legally, though, the question is whether the doctor made reasonable decisions and used reasonable skill at each stage, keeping in mind his training and the facts that would have been known at the time.

So, is it reasonable for a doctor to say that you don't automatically schedule a c-section for a mom who is 4'11"? That's my sister's height, and she had 2 natural births. Ultrasound size estimates can be quite inaccurate, and there's been an outcry in recent years against scheduling c-sections based on a fear that the baby is "too big".

Is 18 hours of labor unreasonable? Many doctors wouldn't worry, unless the baby was in distress or labor continued past 24 hours.

Was the use of forceps unreasonable? We don't know nearly enough to answer. Where exactly was the baby positioned? What sort of forceps were used? What was the purpose of the forceps? Would vacuum have been a less risky option or not? Had the delivery progressed to the point that forceps delivery made more sense than a c-section? Did the OB follow hospital protocol and accepted medical practice?

[So Many Lies]

I think they may have used the ventouse at one point. Has that suction mark on poor baby's head. The forcepts were a plan b. I have also heard of many cases where a doctor has braced themselves on the bed and there's been a good outcome. It's possible there's a reason the c sec was contraindicted. I don't think we have enough facts as these articles are emotive and one sided reporting. I mean c'mon, the Daily Mail.

[twinmama]

Had a delivery with a fourth degree tear. Had c-sections. I'd take the 4 th degree tear any day over the c-section recovery.

It all depends on the person and the particular birth. I had a c-section and recovery was a breeze. No tears to compare it to, but they sound incredibly painful and other than the first couple days, my section didn't really hurt during recovery.

[2xx1xy1JD]

Re birth plans:

They are wishes and preferences, and are NOT legal consent or refusal.

Hospitals have their own consent forms, which usually include a blanket consent to all possible procedures.

Re liability:

No, doctors are not automatically liable for any bad outcome. There are risks inherent with any delivery. Doctors are only liable if they failed to follow generally accepted protocols and procedures and use the appropriate skill expected for their training, given the situation as it presented itself at the time.

If this sounds cold and cruel, consider the alternative: A dire shortage of OBs because nobody is willing to guarantee a perfect outcome in all cases, and a blanket policy of giving c-sections automatically to cut down the risk. The net result of an automatic c-section policy would be more harm to mothers, because a c-section poses more risk to the mother than a vaginal delivery, but higher than average c-section rates are often driven by fear of lawsuits.

[argypargy]

Re birth plans:

They are wishes and preferences, and are NOT legal consent or refusal.

Hospitals have their own consent forms, which usually include a blanket consent to all possible procedures.

Re liability:

No, doctors are not automatically liable for any bad outcome. There are risks inherent with any delivery. Doctors are only liable if they failed to follow generally accepted protocols and procedures and use the appropriate skill expected for their training, given the situation as it presented itself at the time.

If this sounds cold and cruel, consider the alternative: A dire shortage of OBs because nobody is willing to guarantee a perfect outcome in all cases, and a blanket policy of giving c-sections automatically to cut down the risk. The net result of an automatic c-section policy would be more harm to mothers, because a c-section poses more risk to the mother than a vaginal delivery, but higher than average c-section rates are often driven by fear of lawsuits.

While I agree with you for the most part, I don't understand how the doctor can't be liable. The baby's skull was crushed and its spinal cord snapped. Something is not adding up. I'm sorry, you don't end up crushing the baby's skull and snapping its spinal cord if you are correctly following procedure.

[Little Miss Alien]

A very sad story indeed. Looking at the pictures it appears that the baby did take after her father as she looks quite large for a newborn. My consultant estimated my son would be "at least 8lbs" but he was born 7lbs 4.5oz and tiny (his weight is all muscle to this day).

I used to have a job within the NHS dealing with incidents like tjis, and sad to say, it would be very unlikely the doc would be struck off for this. There wpuld be an investigation, during which time the doc may be suspended, which would ultimately identify that there was a lack of training and there would be retraining provided and an apology given to the family. Compensation is rarely forthcpming over here unless the health service Ombudsman rules that there has been gross misconduct/negligence/malpractice. All stillbirths were investigated, but very rarely was there anything more than recommendations for training.

In our society we are now led to believe babies/mothers don't die during birth anymore, but they do, even if rates are low now but they do and it is so very sad, but in the medical world it's seen very much as à (sad) fact and nothing more.

[Chowder Head]

I have had a c-section( belly button to huha) but it was a emergency surgery to removed a torqued ovary with a grapefruit size growth on it. i was in the hospital in pain for two day with only aspirin and was release twice when both times my fever spiked and blood pressure spiked. If my mom wasn't there I don;t think they ever would have diagnosed me till to late. Long story short - I can't imagine that even if she could have consented to forceps she was in the right mind to do so with 18 hrs of labor and high fever.

**side note - I think I recovered from my surgery pretty well and fast but I didnt have a baby to take care of either.

[cindyluvs24]

A very sad story indeed. Looking at the pictures it appears that the baby did take after her father as she looks quite large for a newborn. My consultant estimated my son would be "at least 8lbs" but he was born 7lbs 4.5oz and tiny (his weight is all muscle to this day).

I used to have a job within the NHS dealing with incidents like tjis, and sad to say, it would be very unlikely the doc would be struck off for this. There wpuld be an investigation, during which time the doc may be suspended, which would ultimately identify that there was a lack of training and there would be retraining provided and an apology given to the family. Compensation is rarely forthcpming over here unless the health service Ombudsman rules that there has been gross misconduct/negligence/malpractice. All stillbirths were investigated, but very rarely was there anything more than recommendations for training.

In our society we are now led to believe babies/mothers don't die during birth anymore, but they do, even if rates are low now but they do and it is so very sad, but in the medical world it's seen very much as à (sad) fact and nothing more.

Can the family not sue the doctor then?

[NotALoserLikeYou]

Can the family not sue the doctor then?

Oh this is America. They'll sue. And rightly so.

[2xx1xy1JD]

While I agree with you for the most part, I don't understand how the doctor can't be liable. The baby's skull was crushed and its spinal cord snapped. Something is not adding up. I'm sorry, you don't end up crushing the baby's skull and snapping its spinal cord if you are correctly following procedure.

I'm not saying that he wouldn't be liable. I'm saying that it's impossible to know the outcome based on an article in the Daily Mail. During a trial, you'd have the full medical records, evidence of policies and training and current standards, expert reports, etc. It will be years before all this information is gathered and ready for trial.

[scc12]

I really disagree with them trying to make forceps illegal,due to this one incident.And they probably won't get it to pass.My daughter and I did just fine with them,as I'm sure many others have in the hands of skilled Dr's.It saved me from having a C-section,which I didn't want.

Perhaps the bigger issue,and one which they should push for,is can the mother demand a C-section in certain instances? Of course no Dr worth his grain of salt would do one without a valid medical reason,but in this case,she should have been able to get one easily.

[Coconut Flan]

Since C-sections have been performed because of fear of labor and birth, because an OB thought a baby was going to be too large, maternal exhaustion, and a myriad other less than emergent reasons, it seems that somewhere along the course of ruptured membranes, maternal fever, and a sunnyside up baby, that the glimmer of the thought that in a 4' 11" patient who asked for a C-section that just maybe it was a valid option. Having a scar doesn't sound like a very good reason not to do the section. I'd like to hear the story from the doctor's side though.

[lascuba]

Oh, no way will the doctor lose his license over this, but he will most definitely lose the lawsuit, if he doesn't settle (and I'm sure his malpractice insurer will insist that he settle).

OB have one of-if not THE-highest malpractice insurance premiums for that very reason--if something goes wrong with mother or baby, they're getting sued, and more often then not they'll lose. Tell a jury how much it costs for the lifelong care that a brain damaged baby will need and that's it. There was an awful case in Maryland not that long ago, where the mother was a home birth transfer. The midwife did absolutely everything wrong, they get to the hospital and by the time they got the baby out via c-section he was severely brain damaged. The parents sued the hospital, claiming they didn't act quickly enough when in fact the hospital followed protocol. The hospital refused to settle because they were sure they'd win. The judge declared any mention of the midwife's actions was inadmissible, and boom, payday. And the real kicker, those parents still have a great relationship with the midwife. I swear, those parents make me wish there was a hell.

And there have been other cases of mothers who are so insistent on vaginal births that they refuse c-sections when they're babies are in distress, and when baby was born dead or brain damaged they sue and win. All they have to say is, "But I didn't really understand that my baby could die. The doctor wasn't clear enough," and that's it.

I'm actually all for lawsuits, because there's nothing like the threat of losing money to keep people careful, but for that very reason I have no problem with high c-section rates. We can't have it both ways.

[Little Miss Alien]

Can the family not sue the doctor then?

In the UK they could try to, but it's very rare that they would get anything. They have to follow set procedures - complain to hospital, then the commissioning trust and then if not satisfied, the Ombudsman. The Ombudsman will sometimes recommend comoensation if fault is found but it is rare. More likely is that the hospital has to pay the government a huge fine.

As doctors here are employees of the hospitals or trusts they work for, they can't be sued personally, but patients can attempt to sue the hospital or trust. It's probably different for private practice but I don't work in that sector.

Of course if this couple, being stateside, can sue they should do what they feel is right. For me personally I question how much a life is worth and would money make anything better really? But I'm guessing they have some pretty hefty medical bills to pay off and they shouldn't have to pay that when the doctor's negligence robbed them of their baby.