Delayed C-Section and Cerebral Palsy

Fact Checked

A delayed C-section can lead to complications and brain damage that cause cerebral palsy. A C-section is considered an emergency procedure when the health of the mother, baby, or both is in danger. Physicians must determine if and when a woman needs a C-section to reduce the risk of serious complications.

What Are the Consequences of a Delayed C-Section?

Physicians determine if their patient needs a C-section to deliver a baby safely. They must consider the health and risks to the mother and the baby. Delaying or never performing a needed C-section can harm the mother but also put the baby at risk for:

• Hypoxic-ischemic encephalopathy
• Cerebral palsy
• Brachial plexus palsies
• Physical trauma caused by birth instruments
• Permanent physical, developmental, and cognitive disabilities

What Are the Reasons to Perform Emergency C-Sections?

Physicians are trained to make important decisions like these. There are several reasons they may need to perform a C-section:

Fetal or Maternal Distress

One of the most common reasons doctors decide on an emergency C-section is due to fetal or maternal distress.

For instance, if the baby’s heartbeat is too fast or slow, or if a mother has medical difficulties, doctors can decide to deliver the baby immediately.

Fetal distress can happen relatively quickly, so your healthcare provider must keep a close watch. Within minutes of the onset of distress, an infant could experience oxygen loss, and if not delivered in time, the baby could end up with brain damage that could lead to cerebral palsy.

Prolonged Labor

If a mother’s labor is not progressing as it should, an emergency C-section may become a necessity. Prolonged labor can cause a host of problems. The baby is at an increased risk of oxygen deprivation, sepsis, and intracranial hemorrhage.

These issues can lead to long-term medical complications for the infant, including outcomes such as developmental delays, cerebral palsy, and seizures.

Prolonged labor also poses risks to the mother, such as intrauterine infections, postpartum infections, and bleeding.

Abnormal Birth Position

Babies in a breech position or another malpresentation can, at times, require an emergency C-section.

Typically, a baby is born head-first. However, if the baby is in an unusual position, the progress toward a traditional delivery can become obstructed, leading to prolonged labor and related complications.

In some cases, the shoulder may become stuck in the birth canal after the baby’s head is delivered. This is called shoulder dystocia and is considered to be an obstetric emergency.

Placental Complications

Placental abnormalities, such as placenta previa and placental abruption, can place a baby at risk of oxygen deprivation and sometimes require immediate medical assistance.

Placental abruption occurs when the placenta begins to separate early from the uterine wall.[1] It is a relatively rare occurrence, accounting for around one percent of all pregnancies, and usually happens during the third trimester.

C-section delay in the case of abruption puts the baby at risk of developing hypoxic-ischemic encephalopathy (HIE), a severe form of brain damage that can lead to cerebral palsy.

Placenta previa is an uncommon yet serious medical issue that occurs when the placenta covers some or all of the mother’s cervix. Generally, this will be noted early in the pregnancy and require close monitoring.

There can be severe bleeding if it does not, especially during the last trimester. In some instances, an emergency C-section must be performed before the baby has reached full term.

Maternal Infections and Medical Conditions

Typically, a C-section will be scheduled in advance if the mother has certain medical conditions, such as diabetes or obesity, complications from maternal infections, a previous C-section birth, or other factors that would increase the risk of a vaginal delivery.

Physicians must recognize and diagnose these issues during pregnancy, well before the onset of labor.

If a doctor fails to diagnose in advance any medical conditions that would require a C-section, these types of problems have the potential to cause harm to the baby during vaginal delivery.

Cephalopelvic Disproportion (CPD)

CPD is a medical term for infants too big to fit through their mother’s pelvis, making traditional delivery extremely difficult. However, if CPD is diagnosed earlier in pregnancy, a healthy delivery is possible.

For infants not diagnosed in time, an emergency C-section or an operative vaginal delivery is typically needed.

The causes of CPD can vary. The common reasons include maternal diabetes, hereditary conditions, pregnancy going beyond the due date, small maternal pelvis, and abnormal fetal positioning.

The American College of Nurse-Midwives (ACNM) reports that CPD is considered uncommon. Around 1 out of 250 pregnancies results in CPD.

Prolapsed Umbilical Cord

The umbilical cord plays a vital role during pregnancy; it’s how unborn babies receive oxygen and nutrients. Too much pressure on the umbilical cord can compress it. A prolapsed cord can block nutrients and oxygen from reaching the baby, resulting in numerous medical issues.

A prolapsed umbilical cord can lower an infant’s blood pressure and heart rate, and the resulting loss of oxygen to the brain can quickly lead to brain damage.[2]

Prolapsed umbilical cords usually happen during the third trimester. A baby’s movements can cause a prolapsed cord, as well as preterm premature rupture of membranes.

What Causes a Delayed C-Section?

According to a study of the timing of C-sections, doctors must act very quickly after determining whether an emergency C-section is needed:[3]

“Fetal distress is an emergency condition requiring rapid cesarean delivery. Hence, it has been recommended that the decision-to-delivery interval should be within 30 mins,” the report reads.

Other studies suggest that an emergency C-section should be performed within 10 to 18 minutes of detecting fetal compromise. Regardless, in some situations, emergency surgery fails to be carried out in enough time to prevent complications.

A delayed C-section, as mentioned earlier, can result in serious medical issues, some of which may not be reversible:

Failure to Monitor Fetal and Maternal Distress

Sometimes, healthcare providers fail to monitor for fetal or maternal distress properly. When a pregnant patient is admitted to a hospital, an external monitor that displays the baby’s heart rate is usually hooked up.

It’s up to the healthcare providers to watch the monitor closely, and if they note signs of distress, they must act quickly.

Overbooked and Understaffed Hospitals

Crowded hospitals, busy nurses, and busy doctors can sometimes result in waiting too long to look at the baby’s monitor. However, these moments are crucial as it only takes a short time for an infant to experience oxygen deprivation, which can lead to brain damage, cerebral palsy, and other injuries.

Missed or Delayed Diagnosis

Another reason doctors delay C-sections is due to a misdiagnosis or not recognizing a medical problem in time. For example, in 2011, New York mom Cathy D’Attilo was in her third trimester when she visited her doctor for a routine check-up.

A Stamford obstetrician, Dr. Richard Viscarello, noted that Cathy’s amniotic fluid had dropped to half the amount it should have been. He should have scheduled a C-section immediately, but instead, the doctor sent Cathy home.

Two days later, Viscarello performed a C-section on Cathy and reportedly made incisions in the wrong places. When Cathy’s son, Daniel, was born, he was pale, limp, and not breathing.

Daniel was placed on a ventilator and began to have seizures. He was later diagnosed with a severe form of cerebral palsy and epilepsy. This is an irreversible condition where he cannot talk, eat, or sit up on his own.[4]

His parents have struggled for years to shoulder the financial responsibility of caring for their son. The family eventually won a $58 million lawsuit against Dr. Viscarello and his practice.

The jury in the birth injury lawsuit determined that Daniel’s condition likely could have been prevented had an emergent C-section been carried out when indicated two days before his actual birth.

How to Advocate for You and Your Baby During Labor and Delivery

Whenever a doctor fails to perform an emergency C-section in time, babies and mothers alike are at risk. Doctors are responsible for ensuring that they give patients the best and most expedient care possible.

It’s essential to understand your rights as a mother, whether you’ve given birth to a child who developed cerebral palsy or are currently pregnant or planning a pregnancy.

If something feels wrong, speak up. Talk to the doctor, a nurse, or any other staff member willing to listen.

Medical mistakes are most often accidents made by careless assessments or negligent care. Healthcare providers who make errors that result in birth injuries should be held accountable. Families that have had to deal with the resulting financial and emotional burdens should receive appropriate compensation.

For more information, please get in touch with us at 866-579-8495 for nationwide legal assistance.