Painful Labor and Maternal Injury – Is It Medical Malpractice?

Some women are lucky when they give birth. Their labor is relatively short and they find it relatively painless. Others experience a lot of pain. Why is this, and when does painful labor and potential injury become something that might result in a malpractice suit?

What Causes Pain During Labor?

To address this question, we must first look at why labor is painful in the first place.

Pain occurs during the second stage of labor, when the cervix is open and the child is starting to move into the birth canal. The pain starts in the abdomen or back then moves down into the pelvis, vagina and the area between the vagina and the anus. Some women also experience pain during the first part of labor, when the cervix is slowly starting to open.

The primary reason for the pain is the deep contraction of the uterine muscles as they work to push the baby out. It’s similar to the pain you might experience when working out. In other words, some pain is the natural response of muscles that don’t generally do that much work suddenly having to work very hard indeed. These contractions get closer and closer together, with less time to rest between them. Pain can also be experienced as a result of pressure on the cervix, bladder and bowels, and the stretching of the birth canal and perineum (the tissue between the vagina and the anus) to make room for the baby.

Finally, anxiety about the birth can create and exacerbate pain.

Why Is Pain Different for Individual Women?

Labor pains vary from woman to woman and even from birth to birth for the same woman. There are a number of factors which can affect the amount of pain experienced.

1. Anxiety and tension. Women who are worried about giving birth and anticipating pain tend to experience more pain. Birth training often helps reduce anxiety and anxious women often benefit from the services of a doula, who is essentially a childbirth counselor. Doulas are not medical professionals but can give advice on nutrition and preparing for the birth.
2. Whether it is your first child. Labor tends to be longer and more painful for a first time parent, especially if you are older, especially as the child moves through the vagina. This appears to be related to the stimulation of pain receptors around the vagina and vulva.
3. The level of antenatal education. Women who receive birth training and are better prepared for the experience tend to experience less pain.
4. How in shape you are. Women who continue to exercise during pregnancy and keep their body in good condition tend to have a better experience during childbirth.
5. Your physical shape. While it’s not true that broad hips necessarily mean an easier time giving birth, your pelvic shape can affect how long it takes for the child to move down the birth canal.
6. The size of the baby and the positioning of the baby during labor. Larger babies are obviously harder to deliver, and a breech or transverse presentation can cause major issues.

Excessive labor pain can be harmful to you and your fetus, so it’s important to take steps to reduce it. This generally means proper antenatal education, staying as fit as possible and talking to your doctor about pain management during labor.

When Is Painful Labor a Malpractice Problem?

Some pain during labor is normal. Your body is working muscles that it doesn’t generally use. (In fact, this is what so-called Braxton-Hicks contractions are; your uterine muscles practicing and strengthening themselves in advance of the birth).

However, mistakes by your doctors can increase labor pain. One of the biggest potential issues is not turning a breech baby. Babies are meant to come out of the uterus head first. Breech birth is more likely if the child is premature, during multiple births (due to the smaller sizes), or if there is an excessive amount of amniotic fluid. Sometimes, the shape of your uterus effects this. Excessive fluid can be a particular problem, as it can cause providers to fail to recognize that the baby has not turned. There are various things which can be done to try and turn the baby, but if they all fail a c-section is generally recommended. Not doing an emergency c-section for a breech birth can potentially be malpractice if injury to the baby or mother results.

Drugs During Birth

Another issue is improper administration of drugs during birth. Epidurals are sometimes used to control painful labor. An epidural means pain relievers delivered through a tube into the back, blocking pain signals from reaching the brain. Doctors generally recommend epidurals only when labor pain is too intense. Indeed, it interferes with the woman’s ability to focus or when they are deciding whether to continue with vaginal birth. However, some doctors do tend to reach for epidurals too quickly. Epidurals can have side effects which include severe headaches, seizures, and potential temporary or permanent nerve damage. Vaginal tearing risks increases. Vaginal tearing may require stitching.

Of course, the reverse is also true; painful labor can result when doctors are too slow to provide medication and do not discuss all of your options. This could also be an issue. If your doctor or midwife is pushing you to have a natural childbirth and refuses to change tack if you have an unusual amount of pain, then you may have grounds for a suit.

The amount of pain experienced by a new mother varies between women and between births. This is normal, but when doctors are too fast to reach for painkillers, or too slow, then you may have a malpractice case. You may also have a case if your provider fails to detect and turn a breech presentation.

Experience Painful Labor?

If you or a loved one experienced maternal injury or excessive pain during labor and suspect that the medical provider may have contributed to or failed to mitigate it, then you may have a malpractice case. Contact Weltchek Mallahan & Weltchek to find out how we can help you and schedule a free initial consultation.