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Birth Injuries - Mother

For most people, pregnancy is usually a happy experience. However, complications can occur during any stage of your pregnancy, labour and delivery. Your baby can also suffer complications in the neonatal period following birth.

Medical mistakes in the handling of your pregnancy can sometimes result in complications, not all problems are a result of negligence, but it may be the case that there was a failure to recognise symptoms, or to appreciate the severity of the condition and to treat promptly, resulting in catastrophic consequences.

Premature Labour

Premature labour is a common complication of pregnancy and refers to a baby that is born before the 37th week of pregnancy. Approximately 8 in 100 babies will be born prematurely.

What Causes Premature Labour?

The cause of premature labour is not known in most cases, but it is known that there are common risk factors that can predispose you to premature labour, such as high blood pressure (pre-eclampsia), multiple pregnancy, bleeding during pregnancy (placental abruption), diabetes, birth defects, and cervical incompetence.

The Risks

Premature babies are an increased risk of significant disabilities, which may include visual impairment or blindness, hearing impairment, cerebral palsy and chronic lung problems. There is also a high death rate as some babies are too small to cope with labour.

However, there are some risk factors that your medical team would be expected to be aware of, and if diagnosed promptly, then it may be possible to prevent, or delay premature labour.

For example, vaginal infections such as gonorrhoea, chlamydia, trichomonas and group B streptococcus have all been linked to premature labour and it is possible to reduce the risk by screening for and treating such infections with antibiotics before labour starts. It is not always possible to prevent or delay premature labour, but it may be possible to prepare for a premature birth.

Your medical team would be expected to recognise the signs of premature labour and to act promptly. If there is a delay in diagnosing premature labour then there will be a missed opportunity to provide maximum medical support to the baby. There may be a failure to administer steroid injections which will help mature babies lungs, and help reduce the risk of complications.

In these circumstances, your baby may become very distressed and may be deprived of oxygen causing them to suffer a catastrophic brain injury and severe disabilities. In some tragic cases the injuries suffered may be fatal.

Placental Abruption

Placental Abruption is the separation of the placenta from the uterine lining and is an obstetric emergency. It is the placenta that provides babies with oxygen and nutrients such as glucose.

Delay in delivery can cause serious life-threatening injuries to you and your baby, as the abruption can cause you to suffer a large blood loss and deprive your baby of oxygen causing them to suffer a catastrophic brain injury with severe disabilities and long-term care needs. Sadly, some babies do not survive placental abruption and may be stillborn or die shortly after birth.

Signs of Placental Abruption

No one knows what causes placental abruption, but there are a number of risk factors that increase your risk. Your medical team would be expected to identify any risk factors for placental abruption that may put you at an increased risk of developing the condition, such as high blood pressure (pre-eclampsia), diabetes, smoking, blood clotting disorders, multiple pregnancies, prolonged rupture of membranes, infection, and advanced maternal age, to name a few.

If placental abruption occurs after 37 weeks of pregnancy, a baby is less likely to experience health problems than babies born at earlier gestation.

Treatment for Placental Abruption

Any woman who presents with abdominal pain or uterine tenderness, vaginal bleeding, signs of early labour (contractions), back pain or decreased fetal heart rate or movement should be assessed immediately for placental abruption by physical examination, an ultrasound scan, blood tests and fetal monitoring. Sometimes, the separation is behind the placenta and may not cause obvious bleeding and this is known as a ‘concealed’ placental abruptions. They are diagnosed because of other symptoms such as abdominal pain.

If a severe placental abruption is identified, then usually an emergency caesarean section will be carried out.

If there is a failure to carry out an urgent assessment, or a failure to recognise, or consider, the risk of placental abruption, or a failure to diagnose an abruption by your medical team and a caesarean section is delayed, then you may lose a lot of blood (haemorrhage) and your baby would be at risk of suffering severe disability.

Pre-eclampsia

Pre-eclampsia is a life-threatening condition that can occur from 20 weeks until soon after the baby is born.

Complications of Pre-eclampsia

It is characterised by protein in the urine and high blood pressure which can lead to fits, stroke, multiple organ failure and death of both mother and baby. It can also cause growth problems in the unborn baby.

Symptoms of Pre-eclampsia

Symptoms can be mild or severe and it may be the case that you do not notice any symptoms and are not aware that you have pre-eclampsia.

Pre-eclampsia should be picked up by your doctor or midwife during your routine antenatal appointments when your blood pressure and urine should be monitored.

Symptoms of more serious problems that may occur are:

  • Severe headaches
  • Vision problems
  • Swollen feet and ankles
  • Pain below ribs

Treatment for Pre-eclampsia

The cause of pre-eclampsia is not known and the only way to cure pre-eclampsia is to deliver the baby, usually around 37-38 weeks, but earlier in severe cases. Therefore the aim is to control the symptoms.

If you are diagnosed with pre-eclampsia you should be referred to a specialist. Regular check-ups, blood tests and scans will monitor both the baby’s growth and the blood flow from the placenta to the baby until the baby can be delivered.

A failure to recognise the symptoms of pre-eclampsia, or a failure to appreciate the severity of the condition, and to act promptly, can result in catastrophic consequences.

Breech Birth

"Breech" refers to the way in which the baby is positioned prior to delivery.  If a baby is in the breech position then it can make delivery more complicated as the baby exits the birth canal with the bottom or feet first rather than the normal head-first position.

Babies that are in a breech position are usually delivered by caesarean section because this reduces the risks to mother and baby.

Breech presentation cannot be prevented, and in many cases there is no known cause although there are recognised risk factors.

Problems That Can Occur:

  • Cord prolapse – a prolapse of the umbilical cord can cause oxygen deprivation and brain damage with severe disabilities.
  • Meconium aspiration -  this is when a newborn breathes in (aspirates) meconium (first bowel movement) into the lungs before or around the time of birth. It is usually as a result of distress and can cause obstruction of the airway and pneumonia.
  • The baby’s head may become stuck if the cervix was not fully dilated which could result in damage to the head or neck resulting in brain damage or paralysis.
  • Fractures to the spine or arm

Because most breech babies are now routinely delivered by caesarean section doctors and midwives may not have the necessary skill and experience to deal with a high risk vaginal delivery if they have not undergone regular training and this increases the risk of the baby sustaining a birth injury as a result of medical negligence.

Perineal Tear

A perineal tear is a tear to the perineum which is the area between the vagina and the anus (back passage) that occurs during childbirth and is very common and a natural part of child birth.

Often an episiotomy will be needed to help deliver a baby if the delivery is difficult or there are concerns about the baby’s heart rate. An episiotomy is a cut to the perineum.

Whilst most women recover well without any long-term complications, not everyone is as fortunate.

Identifying a Perineal Tear

Perineal tears are graded by how severe they are:

  • Labial tears – these are tears to the skin on the labia (skin folds around the genital area). These are usually left to heal naturally.
  • 1st degree tears – these are tears to the skin of the perineum. If blood loss is not excessive these can also be left to heal naturally.
  • 2nd degree tears – these are tears to the skin and muscle of the perineum. A midwife will use some local anaesthetic to numb the area and will stitch the tear together. The stitches are dissolvable so do not need to be removed
  • 3rd degree tears – these are tears to the skin and muscle of the perineum, and some of the muscle around the anus. These tears need to be repaired in theatre to stitch the damaged muscle and skin together
  • 4th degree tears – these are tears to the skin and muscle of the perineum, the muscle around the anus and the skin lining the anal canal. These tears need to be repaired in theatre to stitch the damaged muscle and skin together.

Sometimes, perineal tears are missed by the doctor or midwife which can lead to a potential medical negligence claim.

Common Medical Errors:

  • Failing to carry out a thorough examination
  • Failing to recognise the severity of the tear
  • Failing to carry out the repair correctly

Complications of a Perineal Tear

If there is a failure to recognise and repair a third or fourth degree perineal tear you may suffer one of the following complications:

  • Losing control over your bowel motions
  • Passing wind frequently and uncontrollably
  • Feeling an urgency to get to the toilet fast
  • Pain or soreness in the perineum
  • Painful sexual intercourse
  • A fistula (hole) between the anus and vagina requiring surgery
  • Psychological damage

Infection

Certain maternal infections can have serious long-term consequences for babies. Infection can cause miscarriage, babies to be born prematurely, suffer severe congenital defects or problems affecting their vision and hearing. Infections can also cause brain and heart defects and, in some instances, are fatal.

Types of Infection

A. Viral Infections

You may already be immune to a number of contagious diseases, such as German Measles (Rubella) as a result of routine immunisation during childhood.

B. Bacterial Infections

Many women with these infections are asymptomatic. Whilst the infections are not usually serious and are easily treated with antibiotics, if left untreated they can have a serious effect on your fertility.

Untreated infection such as Group B Streptococcus (GBS) may cause sepsis, pneumonia, meningitis, cerebral palsy, blindness, deafness, severe learning difficulties and occasionally death before, during and after birth.

Bacterial vaginosis (BV) if left untreated dramatically increases the risk of premature rupture of membranes and premature delivery, which is the most common cause of complications and death in new-born babies.

If a urine infection is left untreated then bacteria can travel up to the kidneys causing pyelonephritis which has been associated with low birth weight, premature labour, pre-eclampsia.

An untreated bacterial infection can also cause a late miscarriage, or still birth.

Some infections may be asymptomatic and therefore go unnoticed, but if your medical team failed to recognise the signs of an infection, failed to diagnose and treat the infection then you may have a claim for medical negligence.

Loss of A Baby

The loss of a baby before 24 weeks of pregnancy is called a miscarriage. A baby that dies after 24 weeks of pregnancy before or during birth is called a still birth.

Unfortunately, in many cases when a baby is stillborn no cause can be found, although, there are some known causes such as genetic abnormalities, where a defect has prevented the baby from developing fully, inter uterine growth restriction, or the placenta may not have been working as it should affecting the blood supply to the baby, and in these cases the still birth wasn’t anyone’s fault.

But there are some cases where a mistake by your medical team could have caused the death of your baby.

The loss of a baby is devastating, and one that will impact upon your whole family.

If it can be shown that you received substandard care from your general practitioner, midwife or obstetrician during your pregnancy, or after birth, and that this caused the death of your baby then you may be able to make a claim.

How Can We Help You?

When medical treatment goes wrong, only lawyers with expert legal knowledge will do. Here at Joseph James Law we recognise the devastating effect that a catastrophic injury can have. We understand that a serious injury can be a severe financial, physical and psychological burden on the whole family. We understand the importance of compensation and can help you obtain a settlement that will help with any financial and future care needs that you may have. 

Our clinical negligence team have a strong medical background with some team members having previously been Registered General Nurses before qualifying as solicitors. Some of our solicitors are also members of the Law Society Specialist Clinical Negligence Panel and are recognised experts in conducting high value, catastrophic injury claims.

For a free and confidential assessment of your potential claim by our Specialist Clinical Negligence Solicitors please contact us on Freephone 0800 999 1234. 

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