Many of our clients report to us after they or their baby suffered an injury following a traumatic childbirth that they wished they had known beforehand the realities of childbirth. While thankfully many childbirths progress normally without the mother or baby suffering an injury there are a large number which do not.
As lawyers who work in this area it is often our job to work out whether there were signs in the antenatal process which should have alerted the midwives or obstetricians to the fact that our client was going to suffer the injury that later unfolded. We do this by thoroughly reviewing the medical records and the obstetric radiology to work out whether there were warning signs. Often, we find that there were.
Antenatal care needs to be very considered and focused on correctly categorising a woman’s particular risks associated with childbirth. This is a common area where there are breaches of the duty of care. For example:
- A woman who has gestational diabetes is more likely to have a bigger baby which may be more difficult to birth due to difficulties like shoulder dystocia and the birth plan needs to be carefully thought out.
- A woman with rising blood pressure and protein in her urine might be developing pre-eclampsia and may require very close monitoring to avoid developing eclampsia and HELLP syndrome.
- A woman with placental abnormalities should be closely monitored particularly in terms of whether a vaginal birth is appropriate.
- A woman with a history of mental health problems due to sexual violence may not cope with an instrumental delivery.
These risks need to be acted on and the woman’s care should be altered to try and lessen the risk of a traumatic birth occurring. This frequently does not happen and injuries flow to the woman and or her baby as a result.
There are now very stringent consent guidelines in NSW. These obligate clinicians to discuss and explain different modes of delivery with women. It is a breach of these guidelines for a woman to present to a delivery suite not knowing about the different types of instrumental delivery.
Women need to understand before they go into labour what an instrumental delivery means. They need to understand the types of injuries which can flow, for example, from a forceps delivery. The terminology needs to be clear so that women can properly weigh the risks with the assistance of the treating midwife / obstetrician and make an informed decision.
The types of injuries also need to be clearly explained. Perineal tearing may not sound particularly serious, but third (3rd) and fourth (4th) degree tears are serious injuries which can cause lifelong incontinence (urine and/ or faeces), pelvic pain and sexual dysfunction. Avulsion injuries can mean that the pelvic floor muscles become separated from the pubic bone which means that it can be almost impossible to regain pelvic floor muscles function without surgery. These injuries are associated with instrumental deliveries; they need to be discussed antenatally so that informed consent can be given or withheld.
During labour – we frequently see women attending a birthing suite in the early stages of labour and being turned away or not monitored properly. There are often problems which are missed and are symptomatic of a more serious problem brewing. Women frequently say to us afterwards that they trusted the staff to notice these issues not realising that inadequate staff numbers and a lack of senior staff meant that these warning signs were missed and not acted on.
A little about us, we are NSW medical lawyers with offices on the Central Coast and Sydney with specialist personal injury accreditation from the Law Society of NSW. We subspecialise in birth trauma cases. Our lawyers are female and mothers, we regularly speak at conferences and the press about birth trauma, we strive to improve standards for birthing women. We are proud partners of the Australian Birth Trauma Association.
We can help you access financial compensation for: pain and suffering, past and future treatment expenses, past and future wage losses, past and future domestic assistance together with legal costs and disbursements.
There are time limits in NSW, which means you should seek advice without delay. We offer a no win no fee service and we do not charge for our first, non-obligation consultation.