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Failure to monitor can lead to birth injuries for infants, whether before, during, or after childbirth. Birth injuries caused by failure to monitor can range from minor to life-threatening, and in some cases, death. They may include brain damage, nerve damage, or cerebral palsy.
What Is Failure to Monitor?
During childbirth, mothers and infants need to be closely monitored by a medical team (doctors, nurses, etc.) to ensure there are no health issues. If there are issues, monitoring allows doctors and nurses to catch the problems in time before any significant damage occurs.
Healthcare providers generally strive to ensure all procedures are done correctly during childbirth, but sometimes medical negligence occurs when they fail to follow up on a patient or fail to detect and correct a medical issue; this is known as “failure to monitor.”
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Healthcare providers use a fetal monitoring machine during labor to check the baby’s heart rate and pulse before and during birth.
According to the American College of Obstetricians and Gynecologists, “fetal heart rate monitoring is the process of checking the condition of your fetus during labor and delivery by monitoring your fetus’s heart rate with special equipment.”[1]
Electronic fetal monitoring (EFM ) can either be continuous or intermittent. The U.S. National Institutes of Health reports that continuous EFM can lead to higher rates of C-section birth and births that require vacuum extraction. This, in itself, increases the chances of birth injuries.
EFM can be attached externally or internally to the patient. An internal EFM increases the risk of mother and baby. An infant, according to NIH, “is 2.5 times more likely to contract an infection.”[2]
If a nurse, doctor, or any other medical professional responsible for your care fails to monitor the fetal machine closely, it can lead to severe birth injuries.
For example, if a baby’s heart rate drops, that could indicate that the infant doesn’t have enough oxygen. If the baby is being adequately monitored, medical professionals will typically take measures to correct the issue immediately.
If medical professionals fail to monitor, oxygen loss can lead to brain damage, leading to a number of disorders, including lifelong conditions such as cerebral palsy.
Failure to Monitor During Postpartum Delivery
Monitoring after delivery is just as important as monitoring before childbirth. Many tasks go into postpartum care to ensure good health for both mother and baby. Common postpartum duties include:
- Keeping a close watch on the infant for signs of jaundice, abnormal movements, or breathing issues
- Monitoring the mother for excessive bleeding
- Monitoring the mother for any uterine issues or vaginal tearing
- Monitoring for high blood pressure
- Monitor for signs of a possible stroke
The Centers for Disease Control and Prevention reports that around 700 women in the U.S. each year die due to delivery or pregnancy complications.[3]
Some of these deaths could have been prevented if not for medical mistakes or failure to monitor after childbirth.
Failure to Monitor Infants in NICU
After birth, infants with medical issues may be taken to a hospital’s neonatal intensive-care unit (NICU). If the hospital where the baby was born doesn’t have a NICU center, the baby could be transferred to another medical center.
A NICU is designed to save baby’s lives and give them the required medical care to help them thrive. Sometimes these babies, who need specialized and advanced care, end up with birth injuries due to medical negligence.
Depending on the severity of the infant’s medical condition and the reason for going to the NICU, death can occur in specials needs babies without proper medical attention.
According to JOGNN, the most common reason for failure to monitor at NICU centers that leads to injuries is healthcare professionals not following the accepted standard of nursing care, also known as “deviations from the standard of care.”[4]
Failure to monitor babies in NICU can happen for a variety of reasons, including:
- Leaving babies unattended for too long
- Failure to detect distress promptly
- Failure or delay in monitoring breathing for respiratory distress
- Failure or delay in determining intravenous issues
- Failure to monitor infant hypoglycemia
Types of Birth Injuries That Happen After Failure to Monitor
The type of birth injury sustained when a medical professional fails to monitor a baby depends on the type of mistake and the baby’s overall health. One of the most common and most serious types of birth injuries is brain injuries.
Brain injuries include brain bleeding (cerebral hemorrhage), subarachnoid hemorrhage, or cephalohematoma (bleeding between the skull and skull cover).
Brain damage is another common birth injury caused by failure to monitor. Brain damage is typically caused by a lack of oxygen. It can lead to a host of disabilities and disorders, such as cognitive issues, sleeping disorders, muscle spasms, organ issues, and feeding problems.
Some babies with brain damage will need lifelong therapy and medical care. Cerebral palsy is a common disorder that manifests from brain damage.
Cerebral palsy can range from mild to severe. Children with severe cerebral palsy may not be able to feed themselves walk on their own, and a chance they won’t be able to talk without a communication device.
Another common birth injury is a brachial plexus injury, known as Erb’s palsy. It can occur when a physician pulls too hard on a baby’s arm during delivery. If a medical expert fails to monitor an infant properly, their tiny plexus nerves can get stretched.
Other birth injuries can include:
- Shoulder dystocia
- Skin lacerations
- Brain swelling
- Infections
- Broken bones
- Fractured bones
Prognosis After Failure to Monitor
The long-term outlook of birth injuries depends on how severe the injuries are and the type of injury.
For instance, most babies who develop Erb’s palsy will heal within the first year of life.[5] Others will continue to have weakness in the affected arm, and some children may have one arm longer than the other.
On the other hand, a disorder like cerebral palsy lasts a lifetime. Further, cerebral palsy can be mild, with slight symptoms such as shaky movements but with the ability to walk, while another child may have severe symptoms that prevent them from walking and even holding their own spoon.
Whether birth injuries are mild or severe, parents should not be financially responsible if the injures were caused by a healthcare professional’s negligence.
Most states have medical malpractice laws that hold medical professionals and even hospitals accountable for expenses associated with medical treatment, mental health treatment, home accommodations, and other financial factors that result from the birth injury.
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- Fetal heart rate monitoring during labor. (n.d.). American College of Gynecologists and Obstetricians.
Retrieved from: https://www.acog.org/patient-resources/faqs/labor-delivery-and-postpartum-care/fetal-heart-rate-monitoring-during-labor - First do no harm: Interventions during childbirth. (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647734/ - Pregnancy mortality surveillance system. (2020, February 4). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpregnancy-mortality-surveillance-system.htm - Verklan, PhD, CCNS, RNX, M. T. (2004, January 1). Malpractice and the Neonatal Intensive‐Care Nurse. JOGNN:Scholarship for the Care of Women, Childbearing Families & Newborns.
Retrieved from: https://www.jognn.org/article/S0884-2175(15)34137-X/fulltext - Erb palsy - StatPearls - NCBI bookshelf. (2020, June 2). National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK513260/