The labor and delivery process can be emotionally and physically taxing for both mother and child. In most cases, the mother will automatically defer to her doctors and nurses during the delivery stage, trusting them to protect her baby while respecting the terms of her birth plan. But what happens when a doctor acts on behalf of the mother, and his or her choice goes against the approved birth plan? Worse, what recourse does a mother have when the overall experience leads to traumatic cognitive and physical injuries?
Situations of Obstetric Violence
Olivia Miltner, a reporter for Rewire News, discussed this scenario in her article, “It Felt Like I Had Been Violated: How Obstetric Violence Can Traumatize Patients.” She interviewed two mothers, Caitlin Larson and Amy Butz, who both suffered during the birthing process after their doctors violated their trust.
In Larson’s case, “Although her baby had only been crowning for 20 minutes and wasn’t showing signs of distress, her doctor said her son was ‘stuck,’ as her skin hadn’t stretched enough. He announced he was going to cut her...episiotomies are used in under 12 percent of cases, typically when either a baby’s shoulders are stuck behind the pelvic bone, the baby is in distress, or the doctor needs to use forceps or a vacuum.” Larson’s case didn’t meet any of these criteria, and, although she is happy to have a healthy child today, the trauma associated with the birthing process still lingers. She wishes she had more control over the event, and still has mixed emotions about how she didn’t have the choice or ability to challenge the doctor.
Like Larson, Butz’s pregnancy quickly spiraled into a nightmare after the midwife disregarded the birth plan and stripped Butz’s membrane. Butz, who planned to wait until her son was ready to come out, voiced her trauma to Miltner: “As soon as she did it, I knew exactly what she did. And we had just talked about it. I had just said I’m willing to go past my due date, and I trust my body and I trust my baby, and then she did that.” Later, when the doctor came to check on her, he implanted an internal fetal monitor in her vagina – which was specifically not part of her birth plan – even though she was already receiving intermittent reads from an external monitor. Butz added, “Nobody told me what was going to happen until I had this wire hanging out of my vagina. Right after that happened, I told my husband, ‘I feel like I’ve been raped.’ It felt like I had been violated because I didn’t give consent to that.” Feeling that her trust and body had been equally violated, Butz demanded a c-section to regain control of her pregnancy and end this horrific ordeal. Since her delivery, Butz has never wanted to have another child, and often experiences panic attacks whenever she visits a doctor’s office.
Defining Obstetric Violence
In 2017, medical experts completed a study about traumatic childbirth experiences based on the experiences of over 2,000 women. According to the study, nearly 1/3 of all pregnant women experience traumatic births due to a perceived lack or loss of control. As a result, many of these women suffer from postpartum depression, anxiety, and post-traumatic stress disorder.
While not a legal term, “Obstetric violence” is commonly used to describe this specific type of trauma. Unfortunately, it’s become a prevalent problem in the medical community because physicians are afraid of medical malpractice lawsuits. Farah Diaz-Tello, senior counsel for the SIA Legal Team, claims this fear pushes medical professionals to make decisions that disregard a pregnant woman’s personal wishes, and that “The medical/legal concerns and fears of malpractice liability often mean that obstetric violence is used as a form of defensive medicine.”
An “Easy Choice” vs. the Issue of Consent
While doctors need to respect their patients’ decisions, they are also in a catch-22 situation. The courts often hold medical professionals liable for any fetal injuries that occur when a mother refuses treatment. In the article, Kelly Aten, a certified nurse midwife, explains how she always takes an extra minute to thoroughly clarify why a mother should go against her intended birth plan. This gives the mother a feeling of empowerment rather than violation. After all, Aten opines, “Most mothers are not going to choose things that actually put their babies in danger.”
Each year, countless families are financially pressured to file medical malpractice claims against negligent medical practitioners. This includes new mothers who require compensation to effectively care for a child with a serious (and otherwise preventable) birth injury. These lawsuits are usually based on a “failure to act;” for example, if a doctor fails to perform a c-section in a timely manner, the baby may sustain a detrimental birth injury.
Consequently, doctors are aware that they risk a lawsuit if they don’t take immediate action on behalf of the child, even if it disregards the mother’s personal wishes. As Diaz-Tello sums up the situation: “the choice between a battery suit, which can result from harm to the pregnant person, and a negligent suit for an infant who is harmed and may have a lifetime of health-care problems, is easy.”
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