Medical Negligence During Childbirth

Avoidable birth injuries

South Africa is experiencing an unacceptably high perinatal mortality rate and high incidences of obstetric medical negligence. This is according to a joint submission to the United Nations Special Rapporteur On Violence Against Women.

The issue of oxygen deprivation in newborns is especially alarming.

The submission notes that, “…almost half of the deaths that occur due to asphyxia – a complication that can cause cerebral palsy – were preventable…”

Similarly, a 2022 Daily Maverick article reported that cerebral palsy-type birth claims account for as many as 50% of all medical negligence claims in South Africa.

This is just one of the types of avoidable birth injuries affecting newborns.

From 2018 to 2022, the maternity unit in a single Johannesburg hospital was responsible for medical negligence claims amounting to almost R1 billion.

Avoidable maternal injuries and deaths

It’s not just babies who are at increased risk in South African hospitals. It’s mothers also.

In state hospitals, reports of obstetric medical malpractice are widespread. They range from lack of monitoring and delayed medical response right through to verbal and physical abuse.

SA’s latest available maternal mortality ratio (MMR) was 88 deaths per 100,000 live births. This figure has decreased over the past decade. However, it’s still many times higher than the global average of 12 deaths per 100,000 live births in high-income countries.

What counts as medical negligence during childbirth?

If a medical practitioner fails to meet accepted standards of treatment and care expected in the specific situation and either acts or fails to act in a way that results in injury to the patient, it may constitute medical negligence.

Not all birth injuries are the result of medical negligence. However, it’s clear that in South Africa, a large number of birth-related injuries, to both mothers and their babies, could have been prevented through more diligent medical care.

Where a birth injury is a result of medical negligence, the responsible medical professional and/or hospital may be legally liable to pay compensation to the victim or their immediate family.

Avoidable medical errors leading to birth injuries

Among the most common, avoidable errors made by physicians and obstetricians during childbirth include:

• failure to monitor the birth process and anticipate birth complications, such as oxygen deprivation due to a tangled umbilical cord or difficulty in delivery due to the infant’s size
• failure to respond to signs of foetal distress
• failure to order a C-section when necessary
• incompetent use of forceps, a vacuum extractor or other tools
• incorrect use of medication such as oxytocin – a drug widely used in South Africa to induce labour or speed up birth.

Common birth injuries due to negligence

Birth injuries range from minor to severe or fatal, and in some cases have life-long consequences for babies, mothers and their families.

Oxygen deprivation

Oxygen deprivation is a leading cause of birth injuries to South African babies.

It commonly occurs when the placenta separates prematurely, the umbilical cord becomes entangled around the baby’s neck or the baby doesn’t start breathing independently after delivery.

Oxygen deprivation can lead to significant brain damage, hearing impairment, partial or total blindness, learning disabilities, chronic seizures, developmental problems and even death.

Cerebral palsy is a group of non-progressive, long-lasting conditions that cause mobility issues and physical disability. It’s one of the most common injuries resulting from medical negligence during childbirth.

Brachial palsy, Erb’s palsy and Klumpke’s palsy

These injuries occur when the nerve bundle responsible for moving the limbs (the brachial plexus) is damaged. See our articles on Erb’s Palsy and Brachial Plexus injury claims for more information.

The most common cause is shoulder dystocia, a condition that occurs when the infant’s shoulders become trapped in the mother’s pelvic bone during delivery.

This may result from a medical practitioner pulling too hard, or pulling incorrectly, during delivery.

Facial paralysis

If too much pressure is put on the infant’s face during birth, nerve damage may occur, causing facial paralysis. This most often occurs when a physician uses forceps or vacuum extraction to deliver the baby.

Fractures

Bone fractures can occur during delivery, particularly fractures to the clavicle or collarbone. While these may be unavoidable, they can occur when the physician fails to spot complications and perform a C-section, or pulls the infant too hard.

Injuries to the mother due to medical malpractice during childbirth

Serious injuries and maternal deaths most often occur as a result of C-sections.

Medical negligence or incompetence during C-sections can lead to mothers dying from blood loss. They may also cause injury to organs such as the intestines and bladder and result in blood clots, uterine rupture and post-partum haemorrhaging.

If incorrect suturing is performed after an episiotomy or a C-section, this may result in tears, long-term discomfort and other complications.

Other common birth injuries suffered by mothers are vaginal tears, anal fissures and forceps injuries to the urethra, bladder, genital tract and perineum.

What to do if you have a claim for medical negligence during childbirth

Medical malpractice claims are complex and require specialist expertise to prosecute successfully.

If you or your baby has sustained a serious injury during labour and/or the delivery process as a result of medical malpractice, contact us at DSC Attorneys for the best possible legal assistance.