While some people are naturally easygoing, childbirth is a pretty big deal, and most pregnant women go into it hoping that everything goes exactly according to plan, whether that plan is to give birth in a bathtub with no drugs, a planned C-section, or something in between. But sometimes, things can go wrong – very wrong. It's unsurprising that the most common malpractice complaints filed by pregnant women involve neurologically impaired infants, a complication that few mothers plan for. But unfortunately, the trend of litigation is doing very little good.
A 2015 survey by the American Congress of Obstetricians and Gynecologists asked OB-GYNs a series of questions regarding their experiences with professional liability claims, and discovered that an overwhelming majority of doctors had been sued for malpractice. 73.6 percent of respondents reported being sued at least once during their careers, and the average doctor had been subject to 2.59 claims each. Neurologically impaired infant claims were the most common type, at 27.4 percent. However, 47.8 of claims were either dropped or settled without any payment. Another 35.9 percent were settled with payment (an average payment of $1,030,151 for neurologically impaired infants was reported). Of the remaining 16 percent of claims that were decided by a judge, jury, or arbitration, only 33.5 resulted in a payment on behalf of the doctor.
A 2005 paper by Karin B. Nelson, MD, of the National Institutes of Health notes that birth asphyxia was once commonly thought to be the cause of most developmental disabilities such as mental retardation, cerebral palsy, epilepsy, autism, and learning disabilities, but that theory has never been confirmed. Nowadays, birth asphyxia is most often blamed for cerebral palsy (CP), but declines in fetal and infant injuries, including birth asphyxia, "have not been followed by a net decline in the CP rate in any birthweight group." In fact, there's actually been a slight increase in cerebral palsy diagnoses, due to increased viability of premature or otherwise ill infants. It stands to reason that if birth asphyxia were truly the cause of most cerebral palsy cases, a decline would lead to fewer diagnoses. Doctors still can't avoid birth asphyxia in every case, but it's happening much less often, and unfortunately, cerebral palsy rates aren't falling. The Centers for Disease Control state this more plainly: "People used to think that CP was mainly caused by lack of oxygen during the birth process. Now, scientists think that this causes only a small number of CP cases."
One would assume that doctors who have been sued would change the way they practice in order to prevent further lawsuits, and they'd be right, but not in the way they might expect. The majority of doctors aren't "cleaning up their act" or pursuing more education in response to malpractice lawsuits, because most didn't actually do anything wrong in the first place. The ACOG survey revealed that fear of malpractice claims has instead led to doctors turning away high-risk obstetric patients, stopped performing vaginal birth after C-section, or VBAC, because of the (very small) risk of a uterine rupture. This, in turn, has led to the United States have a C-section rate that's double the World Health Organization's recommendation.
Some doctors have even quit practicing obstetrics entirely. The average age at which they give up practicing is now 48, which was once the prime of an OB-GYN's career. In short, lawsuits have led to younger, less experienced doctors who are less willing to treat their patients. Obviously there are doctors who make mistakes, and they should absolutely have to answer for that. But rushing to a lawyer without careful consideration of the facts (and consulting with other doctors first) has implications that negatively impact all patients. Americans are too quick to sue these days, and it's hurting us all.