Canadians seeking healthcare services for childbirth expect that their doctors and nurses will provide competent care, and will take all reasonable steps to ensure safe delivery. There are many risk factors associated with childbirth, most of which can be managed by appropriate medical care. When doctors, nurses, and other medical professionals fail to manage risk factors associated with childbirth, their negligent actions can result in lifelong harm and permanent impairment.
The term “failure to progress” refers to an unusually long or protracted course of labour. Failure to progress during labour increases the risk of complications to both the baby and the mother. Failure to progress can occur in either the first or second stage of active labour and is characterized by labour that has a slow progression and lasts more than 20 hours, or labour that becomes “arrested” when contractions stop altogether.
During the first stage of labour, the mother will begin to feel regular contractions as the cervix dilates. This allows the baby to move into the birth canal. Failure to progress in the fist stage of labour can be caused by either “protracted” or “arrested” labour. In cases of protracted labour, failure to progress is defined as less than one centimeter of cervical dilation per hour for at least four hours. In cases of arrested labour, failure to progress occurs when there is no cervical dilation at all for two hours or longer. Failure to progress during the first stage of labour can be exhausting, but generally is not dangerous for either the mother or the baby. Failure to progress in the first stage of labour is specifically common in cases of induced labour, where the cervix takes longer to dilate than in cases of spontaneous labour.
During the second stage of labour, the baby moves through the birth canal. Failure to progress during the second stage of labour generally occurs when the uterine contractions are not strong enough to push the baby through the birth canal, the baby is improperly positioned, or when the baby is too large to easily pass through the maternal pelvis. A prolonged second stage of labour can increase the risk of dangerous complications to the mother and baby, including infection, postpartum hemorrhage, uterine rupture, fetal distress, lack of oxygen to the baby, and shoulder dystocia. When there is failure to progress during the second stage of labour, medical professionals must be prepared to intervene to prevent injury to the mother and baby.
Babies that are stuck in the birth canal for prolonged periods of time are at a higher risk of depleting their oxygen reserves and suffering brain injury as a result of oxygen deprivation during labour. Mothers who experience a prolonged second stage of labour are at a higher risk of suffering uterine rupture and requiring an emergency hysterectomy.
In some cases, a prolonged second stage of labour can be properly managed by medications or alternative techniques to promote a vaginal delivery. In other cases, doctors and nurses should be prepared to use assistive interventions such as a vacuum or forceps to encourage delivery of the baby. In serious cases, medical professionals should be prepared to perform an emergency Cesarean Section (“C-section”) to prevent potential injury to the baby as a result of prolonged labour.
There are many possible complications that arise from failure to progress during labour, and therefore it is imperative that doctors, nurses, and other medical professionals constantly monitor the progression of labour and are prepared to intervene when necessary. When medical professionals do not intervene in a timely manner in prolonged births complicated by a failure to progress, both the mother and baby are placed at an increased risk of developing a serious and permanent injury. Negligent management of prolonged labour or delayed intervention by doctors can cause permanent harm to the mother and/or baby.
When doctors, nurses, obstetricians, and other medical professionals fail to properly intervene during a prolonged second stage of labour, they can be held liable in medical malpractice claims for the injuries that were caused by their negligence. If you or your child suffered an injury as a result of a failure to progress during labour, you may have grounds for a successful claim in medical negligence.
To be successful in a claim of medical malpractice, one must prove that the harm or injury suffered was a result of the doctor or nurse’s negligence. This is a legal element known as “causation”. It is important to remember that not all birth injuries were caused by physician negligence. The experienced medical malpractice lawyers at BIMMA have extensive experience evaluating birth injury claims to determine whether it is likely that causation can be proven. The medical malpractice lawyers at BIMMA can provide you with a no-obligation consultation to help you decide whether legal action is the right path for you.
