Caesaren sections, commonly termed “C-sections,” have been around for centuries. There are reports of C-sections being performed as early as the 13th century. Early C-sections were performed to remove babies from the wombs of mothers who had died during childbirth. Modern Caesaren sections, of course, are a great life-saver for mothers as well as babies. As with all advances in medicine, C-sections create their own risks and quandries.
C-sections are indicated in many instances when the natural birth processes are not progressing smoothly. A partial list of indications for a caesarean section, would include cephalopelvic disproportion (baby’s head too large to progress through pelvis), fetal or maternal distress from any of a variety of causes, breech or transverse position of the fetus, cord prolapse, uterine rupture. In recent years, obstetricians have largely agreed that C-sections should not be done routinely, for the mother’s convenience, or for cases of ordinary difficulty in the birth process.
Nevertheless, if a mother or infant is in trouble because labor is not progressing or induction of labor or attempted instrumental delivery have failed, the obstetrician may be obligated to perform a C-section. Many significant verdicts and settlements in birth negligence cases, have resulted from the obstetrician’s failure to perform a Caesaren section, when a C-section was indicated to protect the mother or baby. As with every medical procedure, it must be performed in a competent manner. A multi-million dollar settlement was reported in last week’s Massachusetts Lawyers Weekly, when the obstetrician and anesthelogist involved in a C-section, failed to realize that the mother was bleeding from ruptured uterine blood vessels. By the time the bleeding was recognized and the source of the bleeding located and repaired, the mother had suffered irreversible brain damage because her blood pressure dropped below levels necessary to carry sufficient oxygen to the brain.
Failure of communication between the medical team was involved in this woman’s tragedy, as is often the case. A nurse and anesthesiologist were treating the woman for shortness of breath due to dropping blood pressure, but neither of them notified the obstetrician of the problem for several hours. Lack of communication amongst health professionals treating the same patient, is a recurring theme in this blog site, and will continue to be, as failures of communication are responsible for many instances of medical negligence causing death and serious injury.