Like many women, when you became pregnant with your child, you likely planned to deliver vaginally. However, your doctors were responsible for telling you if they ever determined that delivery by C-section was the best option. It is very important for all physicians and midwives know when to make these calls, because C-sections can help avoid disastrous birth injuries, many impacting your child for the rest of their life, and they can protect your health. If your child has an illness, disability, or even died after birth, then it is important for you to know if a cesarean section could have prevented your child's health problems. Read on to find out if this call should have been made before your delivery date or when you were in the delivery room and what can occur when a doctor does not call for a C-section when it is needed.
When Responsible Doctors Should Call for Planned C-sections
Before your delivery date, your OBGYN should tell you that you absolutely need a C-section if your baby is feet-down in your womb, you are expecting twins or triplets, or you have a vaginal infection your baby could catch during delivery (such as herpes simplex). In addition, if you previously delivered a child through C-section, you should be told to have an additional C-section to avoid uterine rupture. If you have heart disease or high blood pressure before you deliver, then a C-section should also be considered carefully by your OBGYN.
When Doctors and Midwives Should Call for Them During Delivery
If you and your baby don't meet any of the criteria that call for a planned C-section, then you should also know when emergency C-sections should be called for in the delivery room.
The most important time to call for an emergency C-section is when your delivery is taking too long. Prolonged labor can be caused by a large baby, a small birth canal, or weak contractions. If your delivery delay is caused by a large baby or small birth canal, then a cesarean section should be called as soon as these factors are determined to be the cause, since these factors will not change. When you have been delivering for longer than about 14 hours due to weak contractions, your doctor should first begin measuring the strength of your contractions and give you a medication to attempt to increase them. During this time, your baby should also be hooked up to an Electronic Fetal Monitoring system to ensure their heart rate is remaining normal. You should never be allowed to stay in labor for longer than 18 hours before your doctor or midwife calls for a C-section.
There are multiple reasons that labor should not be allowed to continue past the 18-hour mark. First, your baby's head is compressed during the delivery process. While compression for a short period of time is natural and will not harm your child, after 18 hours of this compression, your baby's brain and body will know there is something going wrong and its blood pressure will increase. After prolonged labor, your baby may also start experiencing an irregular heartbeat and become deprived of oxygen leading to fetal distress.
An emergency C-section should also be called at any time during delivery if your doctor or midwife determines that your umbilical cord may be wrapped around your baby's neck, or if you or your baby show signs of distress at any time.
What Happens when Doctors and Midwives Don't Make the Right Call
Physicians and midwives both have advanced training and education that should lead to them knowing exactly what to do to ensure a baby is delivered in great health. When they make mistakes, like not calling for a C-section when needed before and during labor, they harm the lives of babies and mothers.
Oxygen deprivation during delivery, called perinatal asphyxia, often occurs during delayed labor that is allowed to persist without a cesarean section being called. It often leads to a neurological disorder in your baby called neonatal encephalopathy. This disorder typically causes your baby to have trouble breathing on his or her own and have a lack of a normal consciousness that babies typically have. It can also cause seizures and can lead to heart problems and liver problems. When the disorder is mild, it may take several weeks of intensive care until a baby can breathe and function on their own. More severe cases can lead to life-long disability and even infant death. However, most babies who begin life with neonatal encephalopathy never reach their full intellectual potential and have to live with lower-than-average IQs for their entire lives.
If your OBGYN did not insist on a C-section delivery when they knew that you had heart disease or other major health problems, then you and your baby could both die in the delivery room.
If you suspect that you or your child's medical problems or death could have been avoided if a doctor had called for a C-section, then speak with a medical malpractice attorney. If you are unsure what led to your baby or child's health problems or yours that began after delivery, then a good birth injury lawyer can gain access to important documentation prepared by your OBGYN, delivery room doctors, and midwives before and after you delivered that may finally give you the answers you need.