Posted by Bill Sandweg on 21 June 2021.
There are few things more devastating than a baby who dies or is badly injured during childbirth. What should have been a happy occasion for celebration turns into tragedy. The gaily decorated room at home prepared in anticipation of the arrival of the new baby is now a sad reminder of what could have been. Sometimes, it is just God’s will that the baby will die or be damaged. There is nothing anyone could have done. Other times, the baby’s death or injury is due to human error. That is when parents should come to see me.
Human mothers have been giving birth to babies for hundreds of thousands of years. Childbirth is a dangerous time for baby and for mother. Many mothers died during childbirth over those hundreds of thousands of years. It is only in the last hundred years or so that medicine in the developed world has been able to make a difference in whether a baby makes it or not and whether mom will be there to raise her baby.
The men and women who work in Labor and Delivery units at our hospitals are well-trained and are usually experienced. They are caring people. They want to do the right thing. They want to send mothers home with healthy babies. But when you come to work every day and care for laboring mothers, it sometimes becomes routine. It sometimes becomes a job. It sometimes gets taken for granted. That is when mistakes happen.
Nurses and obstetricians are just like us. They have their good and bad days. They have all the worries and cares about their families and about how to pay the bills as the rest of us. Unfortunately, when they have a bad day or get distracted by personal issues, something really bad can happen.
There are lots of factors that lead to bad outcomes in Labor & Delivery. Communications are always a potential problem. The labor and delivery process is an active one. Things are constantly changing. Mother is laboring and, in the best case, moving toward a vaginal delivery of her baby. The doctor is often not at the bedside as the mother labors. It is the responsibility of the labor nurse to monitor the mother and to keep the doctor advised of all pertinent information about the mother and the baby. The doctor has to rely on the nurse to pay attention, to accurately assess what is happening and to accurately report it to the doctor. Mistakes and misunderstandings can and do occur.
Miscalculations are another problem area. The doctor does not need to be present during all parts of the labor but does need to be present in the event of problems and does need to be present at the delivery. Sometimes, however, baby surprises everyone and comes before she is expected. Sometimes that is before the doctor can get to the hospital.
Doctors make the big decisions. When they fail to make the correct decision or fail to respond to a developing situation, sometimes nurses are reluctant to call them out. There is a great difference in the power of the doctor compared to the power of the labor nurse. The doctor may discourage the nurses from calling him or her too often with reports of the baby’s progress. The doctor may intimidate the nurses and make them hesitant to second guess the doctor’s decisions. Sometimes bad things happen that could have been avoided had the nurses spoken up.
Too much reliance on technology can be a problem as well. If no alarms are going off, nurses may assume everything is going well when it isn’t. They may misinterpret the fetal heart monitor strips as showing a well-oxygenated baby with good reserves when, in fact, the opposite is true.
The bottom line is that labor and delivery is a dynamic process in which things are constantly changing and in which something can go wrong very quickly. The doctors and nurses involved in monitoring the labor and delivering the baby can make mistakes, which may result in the death of the baby or a serious injury. If your baby died during childbirth or was born with a serious injury, you should give me a call. We can get the records and see whether your tragedy was unavoidable or whether someone did not do what they should have done.