Signs Your Labor and Delivery Were Mishandled

Warning Signs That Your Labor and Delivery Were Mishandled

1. The fetal heart monitor showed problems and no one acted. Late decelerations. Prolonged decelerations. A flat tracing. A bradycardia. These patterns are well known and have to be acted on. When the strip shows trouble for an hour and nothing changes, that is a major red flag.
2. The C-section was ordered too late. The standard is generally that an emergency C-section should be started within about 30 minutes of the decision. When it took much longer, because the OR was not ready, because the surgeon was not available, because the anesthesiologist was not there, the baby may have been deprived of oxygen during that delay.
3. Pitocin or Cytotec was used inappropriately. Drugs that strengthen labor contractions must be used carefully. Too much medication can cause contractions that are too strong, too long, or too close together. The baby cannot recover between contractions. Oxygen deprivation can follow.
4. A trial of labor after C-section (VBAC) went wrong. A previous C-section creates a risk of uterine rupture during a VBAC. If the hospital was not equipped to respond quickly, or if the team did not recognize the warning signs of rupture, the result can be devastating.
5. Shoulder dystocia was mishandled. The baby’s head delivered, but the shoulders got stuck behind the mother’s pelvic bone. There are specific maneuvers for this. When they are skipped, done wrong, or done in the wrong order or when too much pulling force is used, the baby can suffer permanent nerve injury or oxygen deprivation.
6. Vacuum or forceps were misused. These tools can be safe in trained hands. They can also cause serious head and brain injuries when used too aggressively, in the wrong position, for too long, or in the wrong patient.
7. The mother was injured during delivery. A severe tear that was not properly repaired. An emergency hysterectomy that may not have been necessary. A serious bladder, ureter, or bowel injury. Major bleeding that was not stopped in time. A brain injury or cardiac arrest. Any major injuries to mom are red flags worth investigating.
8. Postpartum hemorrhage was missed or treated too slowly. Mothers can bleed heavily after delivery. Hospitals have protocols to recognize and respond. When the bleeding was severe and the response was slow, the mother can end up with permanent organ damage or worse.
9. The baby needed resuscitation and the team was not ready. The pediatric team should be available for any high-risk delivery. When they were not in the room, or when the resuscitation was clumsy, the baby’s outcome can be much worse than it had to be.
10. No senior physician was involved when one was needed. Residents and nurses are part of the team. But when a delivery is going off track, an experienced attending obstetrician needs to be hands-on. When the attending stayed away for too long, problems can spiral.