Emergency caesarian sections (also known as c-sections) may be necessary in situations where labour does not progress as it should, or where complications arise. In such circumstances, an emergency c-section may be necessary to keep both mother and child safe and prevent additional complications or serious birth injury. Sometimes, even with an emergency c-section, there is birth injury or hypoxic brain damage. In those situations, we strongly recommend that parents contact a medical malpractice lawyer to investigate the circumstances of their child’s brain injury.
As we have previously blogged, birth asphyxia (or perinatal asphyxia) can cause a baby’s permanent brain injury, leading to low Apgar scores, resuscitation, hypoxic-ischemic encephalopathy (HIE) or Neonatal encephalopathy (NE), neonatal seizures, developmental delay and cerebral palsy (CP).
Fetal Distress: Situations Where C-Section May Be Necessary
An emergency c-section may be required where the following presents:
- Umbilical cord complications (including umbilical cord prolapse, umbilical cord compression, nuchal cord);
- Excessive uterine activity/contractions (tachysystole) especially after oxytocin/pitocin;
- Shoulder dystocia;
- Placental/Uterine issues (uterine rupture or placental abruption);
- Maternal issues (maternal exhaustion, arrested labour or failure to progress in labour);
- Baby in breech position.
In all the above situations, the baby may be in distress (fetal distress) usually detected by their fetal heart rate tracing. Babies in distress are almost always suffering from a lack of oxygen (i.e. hypoxia) and must be delivered as soon as possible, since any delay can significantly increase the risk of newborns suffering from brain damage and hypoxic ischemic encephalopathy (HIE), leading to serious birth injuries including developmental delays, cerebral palsy, Erb’s palsy, and other life-altering conditions. In the most severe cases, oxygen deprivation at birth (also called perinatal asphyxia or intrapartum asphyxia) can lead to death.
Delivering the baby is the best way to give him or her oxygen and/or other required medical procedures (including resuscitation). Where the distressed baby cannot be delivered vaginally in a safe and timely fashion, an emergency c-section must be performed.
Preventing Birth Injury
Recognizing fetal distress and quickly delivering a baby, including through emergency c-section, are two of the most important aspects of preventing a serious birth injury.
The best way to detect a baby in distress is to monitor their fetal heart rate. In a nutshell, when a baby becomes deprived of oxygen, their heart rate will appear abnormal on the fetal heartrate monitor. This can cause the heartrate to rise (tachycardia) or drop/decelerate (bradycardia). This is often the only indication during labour that something may be wrong. During delivery, doctors and the other health care professionals present have an obligation to identify any complications that a reasonable medical professional would be able to identify and respond to in similar circumstances. This includes closely monitoring fetal heart rate and identifying signs of distress, especially the signs of distress that warrant delivery.
Where changes to the fetal heart rate appear and signs of fetal distress are recognized, doctors must quickly respond.
Delayed C-Sections and Birth Injuries
The failure of a medical professional to properly respond to fetal distress, or their delayed response to signs of complications, can increase the length of time that a baby suffers from oxygen deprivation (called hypoxic insult or anoxic insult). This, in turn, can significantly impact the level of permanent injury suffered (hypoxic injury).
In some cases, physicians and other medical professionals may be reluctant to perform an emergency c-section where a baby shows sign of fetal distress. Instead, they may attempt other treatments first, including using forceps or a vacuum.
In other cases, fetal distress is undetected or simply not detected quickly enough and the baby is left in oxygen deprivation for too long. This can occur for many reasons including where a hospital is understaffed, where delays occur or if the staff are simply not competent to read the heart rate tracing and report it.
When a baby is in distress and suffering from a lack of oxygen, the effects of the deprivation can get exponentially worse very quickly. Just a few minutes can make a significant difference in the types of injuries suffered, and whether that child may be impacted by what happened during delivery for life.
If you would like to discuss a potential birth injury case with one of our highly experienced Toronto birth injury lawyers, contact Sommers Roth & Elmaleh. We are committed to getting our injured clients and their loved ones the legal assistance and guidance that they need following a medical error, including misdiagnosis of fetal distress and failure to perform a timely c-section. We work hard to secure financial assistance for the future of each of our clients. We take cases on a contingency basis only, ensuring that families can obtain the help they need, at the time that they need it most. We have been helping patients and families whose lives have been impacted by medical malpractice for more than 40 years. We have assisted clients in all over Ontario and from all across Canada, including Newfoundland, Quebec, Saskatchewan, Alberta, and British Columbia. Call us at 1-416-961-1212 or contact us online for a free consultation.
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