Should Doctors BE CALM About Birth Injuries?

by | Aug 8, 2022 | Medical Malpractice

The birth complication rate in the United States has increased over 30 percent since 2014. As the number of serious complications increases, one would think that doctors would be better prepared to deal with them. Legally, they have a responsibility to be prepared for the unexpected, because doctors have a fiduciary duty of care. 

Nevertheless, many medical professionals are either totally unprepared for such emergencies, or they over-rely on outmoded assistance models, like the BE CALM birth injury mnemonic device.

Doctors often panic and make unwise decisions when the pressure is on. But a Lexington personal injury attorney always takes a measured approach when things go sideways. We know that things don’t always go according to plan, especially when the opponent in an injury case is a large medical insurance company. So, instead of getting out of sorts in these situations, we continue working to obtain maximum compensation for your serious injuries.

Breathe, Don’t Push

Shoulder Dystocia (SD) is one of the most common birth complications in Lexington. Quite simply, the baby’s shoulders are so broad that the infant gets lodged in the mother’s birth canal.

In SD emergencies, excessive force, like hard maternal pushing, usually makes the situation worse. Additionally, excessive pushing wears out the mother, so she’s less able to see a difficult delivery through until the end. 

So, advice to breathe instead of push is good advice. Frequently, the decreased pressure allows the baby to slip down the birth canal. If nothing else, breathing instead of pushing allows mothers to preserve their strength.

Elevate Legs

Once again, so far, so good. The McRoberts Maneuver, which involves elevating the mother’s legs above her body, is about 80 percent effective. In this birth position, gravity works in the mother’s favor, instead of against her. The additional, gentle force is often just what the baby needs to keep moving out of the mother.

Our math isn’t very good, but we’re pretty sure that 80 percent is a lot less than 100 percent. So, there’s a good chance that the McRoberts Maneuver will fail and precious time will tick off the clock.

Time is critical in SD situations. If the baby gets stuck, the umbilical cord could wrap around the baby’s neck and cause brain asphyxia in only five minutes.

Call for Help

We’re only at item number three, and already, things are starting to go south. The advice to call for help is good. But it should be higher on the list, because by this time, the five minute window has shrunk to about four minutes. Moreover, most difficult deliveries don’t occur at large hospitals during business hours. So, the nearest help might not be very near.

More importantly, many doctors skip this step, mostly because of professional pride. To many doctors, asking for help is a sign of weakness. This dangerous mindset affects patient safety in other areas as well, such as misdiagnosis of complex medical conditions.

Apply Suprapubic Pressure

Basically, performing suprapubic pressure is like performing CPR on the mother’s abdomen. The excess pressure could push the baby down the birth canal. However, as mentioned above, excessive pressure often does more harm than good in these situations.

Most newborns don’t weigh much more than a two-liter bottle of soda. Therefore, any excessive pressure, even if it’s relatively gentle, could cause a serious head injury or other neonatal injury. Usually, these injuries are permanent. Despite the risks, many doctors apply suprapubic pressure at this point, mostly because they’re desperate.

EnLarge Vaginal Opening

This desperation continues in the next step, as the brain asphyxia clock winds down even further. 

Once upon a time, physicians routinely performed episiotomies, which are small incisions on the mother’s perineum which enlarge the birth canal, whether the mother needed them or not. In 2006, the American College of Obstetricians and Gynecologists encouraged doctors to halt this practice, because these incisions are ineffective and dangerous. Nevertheless, vaginal opening enlargement is still on the emergency list.

Rotational Maneuvers

In plain English, rotational maneuvers means the doctor reaches into the mother’s vagina, grabs the baby, and tries to move the baby to a better position or pull the baby down the mother’s birth canal. Since newborns are so tiny, this barbaric practice often causes a serious nerve or other injury. For example, if a doctor stretches a baby’s arm, that motion severs brachial plexus nerves and causes permanent facial paralysis.

Instead, the last item on this list, or better yet earlier on the list, should be a crash C-section. These surgical procedures are risky, especially if the medical team must perform them on the fly. However, the risk of serious injury is even higher if doctors perform episiotomies or grab the baby’s body parts and hope for the best.

Injury victims are usually entitled to substantial compensation. For a free consultation with an experienced personal injury lawyer in Lexington, contact the Goode Law Office, PLLC. We do not charge upfront legal fees in these matters.