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Obstetric insurance premiums are forcing many specialists and physicians out of practice due to unpredictable birth related disabilities, particularly cerebral palsy (CP). Cerebral palsy is a generic name for a combination of symptoms caused around the time of birth or while the child is still a young infant, the cause of which in the majority of cases are unknown. Studies have found that in the majority of CP cases, the insult could not have been avoided, regardless of the mother undergoing a Caesarean section. Birth asphyxiation, or reduced oxygen supply to the baby's brain due to prolonged labour is only one of many causes of CP, with in utero infections, genetic abnormalities, one twin death in utero, fetal or new born stroke, umbilical cord asphyxiation and prematurity also recognized CP risk factors. Most of the successful court cases suing obstetricians for their child's disability believed to be sustained due to the doctors negligence or malpractice are poorly justified and based on inaccurate assumptions. Electronic fetal monitoring (EFM) of the baby during labour was invented to detect and prevent distressed babies from suffering a lifelong curse of CP. However, EFM has not been found to improve outcome of the baby due to intervention encouraged by non-reassuring EFM traces as interpreted by birth attendants. Rather, it has promoted an increase in Caesarean sections, placing the mother at greater risk than natural childbirth due to surgical complications and yet the prevalence of CP remains steady over a number of years despite EFM and C sections. In most cases of CP, the cause, course and outcome of the condition is unpredictable and therefore unavoidable, negating any grounds for successful litigation. If current beliefs and legal practices are not rectified, the practice of obstetrics will become endangered.
Source: summary of medical news story as reported by JAMA
About: Obstetrics and litigation backlash
Date: 5 October 2005
Author: Alastair MacLennan, Karin B. Nelson, Gary Hankins, Michael Speer
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