The Lawyers Will Always Be Circling

Advertising for clients to bring claims following vaginal breech birth (VBB) mishaps is easy to find, just check billboards, phone directories, TV, and online articles. Although distasteful, directing some attention to these advertisements is important for your practice. Breech deliveries are regaining support and acceptance in the obstetrical/midwifery community. However, society and the plaintiff’s bar are lagging behind in this regard. Greater acceptance for this mode of delivery has been a long time coming in mainstream maternity care, opening up new opportunities for safe birthing in our communities.

Because vaginal breech deliveries are relatively uncommon, attorneys are always anxious to attract breech birth clients, hoping for mistakes and elevated jury awards. Understanding why and how birth injury claims can affect your practice is crucial. The overly dramatic nature of legal advertising should not deter you from acquiring the skills for responsible vaginal breech practice. But, you must maintain an awareness of the standard legal claims being made following complicated breech deliveries. If you want to gain the competence to assist women in appropriate breech deliveries you must certify your breech practice by availing yourself to all the specialized obstetrical/midwifery mentoring, education, experience and litigation protection that is available to you.

Attorney advertising schemes may be utter nonsense but that doesn’t mean they aren’t convincing to the general public. It is not unusual to see print advertising which includes lists describing how breech deliveries are mismanaged. Scenarios of care provider negligence include: failure to appreciate warning signs in breech labors, physical injuries suffered by mothers and babies, hyperbolic claims of specific breech mismanagement (like head entrapment) and, finally, the legal implications (for instance: monetary claims for midwifery/ob negligence, a child’s lifetime medical expenses, non-economic damages affecting the entire family, and loss of enjoyment of life).

Following are examples of how trial attorneys may attempt to educate the public (often erroneously) about breech deliveries gone wrong and how they can “rescue” an uninformed public. Typical malpractice claims:

1. Failures of ob and/or midwifery to discover breech presentations prior to birth. This is considered to be medical negligence. They will make statements that suggest all breech presentations can be identified during prenatal care. As providers, we know that is not always true.

2. Vaginal breech deliveries are inherently riskier than simple surgery and require specialized techniques. Using ‘outdated’ or incorrect methods during delivery can harm both mother and baby. Another partial truth lacking qualification.

3. Lack of emergency preparedness. Delays in performing a c-section when necessary can result in preventable injuries.

4. Negligence is not about every negative outcome but rather failing to act in a ‘manner consistent with accepted medical practice’.

Legal Examples of Mismanagement

1. Failing to detect fetal distress during labor or monitor the baby’s heart rate can have devastating consequences.

2. Delayed Action – Not making timely decisions like opting for a c-section, increases the likelihood of complications.

3. Inexperience – Breech deliveries require skilled medical professionals. Inexperienced practitioners (midwives) may lack the training or expertise needed to safely manage such cases. In the law, untruths can still be convincing.

4. These errors underline the importance of rigorous training, proper planning, and adherence to ‘medical standards in obstetric care’. They won’t even address the possibility that a midwife can competently handle a vaginal breech delivery.

Some Law firms Use Scare Tactics Including How Much They Have Earned in Settlements and Verdicts

1. “We have won more than $2 billion in settlements and verdicts, including a multi-million dollar verdict against a hospital on behalf of a client whose baby suffered a brachial plexus injury when an inexperienced resident ‘performed’ a breech delivery. They are proud to include an additional settlement of $1 million dollars against the doctor.

2. Potentially liable parties: Obstetricians, Midwives, Nurses, Hospitals, and Birthing Centers. This particular firm erroneously claims that cesarean sections generally carry fewer risks than vaginal breech deliveries, and doctors may be liable when they “fail to choose the safer option”. Of course, this pronouncement is incorrect, as the evidence based literature clearly outlines. Choosing cesarean section over an uncomplicated breech presentation vaginal delivery is NOT, in each case, a safer option.

3. Attorney ads will proclaim that if a baby is found to be in a breech position, an early option is external cephalic version. This is correct. However, to insist that a failed version automatically indicates cesarean section is not. It is interesting to note that these law firm ads fail to mention any maternal autonomy or independent decision making regarding her child and her body. The not-so-subtle premise is that delivery decision-making is the sole responsibility of the physician (or midwife), ignoring the wishes of the mother.

4. “A doctor who exercises a reasonable standard of care avoids all of the risks of breech delivery by performing a cesarean section for every breech presentation. Doctors who attempt breech deliveries expose mother and baby to an unnecessary risk of harm.”

5. “We are ready to prove that the doctor violated the standard of care by attempting to deliver a breech baby at all . . .” In any circumstance. This is pure ignorance and out-of-date thinking which will not be effective at trial.

My all-time favorite ignorant attorney statement: “ Breech position is a complication of childbirth”. We know that breech presentation is a relatively uncommon occurrence requiring specialized knowledge and skill but, by its self, is not a complication.

Lawyer Advertising, continued . . .

Breech presentation is associated with numerous complications, including head trauma and brain bleeds, as well as umbilical cord problems, according to one law firm. Many injuries also arise from the baby being deprived of oxygen during the labor and delivery process. Failure to safely and quickly deliver a baby who is in a breech presentation can cause the baby to experience a lack of oxygen in the brain. . .

This particular ad was obviously lifted from an Obstetrics Textbook written in the 1960’s. Modern and experienced breech providers know that speed is not related to a successful breech delivery. Speed = Interference. We know that educated breech birth assistance does not include pulling, yanking etc. These are NOT supported or recommended maneuvers.

Of all the advertisements I have reviewed, this one dealt, specifically, with all the ways a lawyer can successfully sue a midwife. Particularly home-birth midwives who are featured as particularly threatening because “they do not have the proper resources available for emergency medical care”. Their major accusation is that negligent midwives “fail to take emergency actions when situations arise during labor and delivery”. This is, basically, home-birth fear mongering, suggesting that midwives do not plan for initial resuscitation, transport, hospital contacts, etc.

The cherry on the cake of this advertisement is: Midwives may use excessive force during a breech delivery. The last individuals on the face of this planet that would ever use force during a breech birth are experienced and trained midwives.

They close their narrative by suggesting that midwives (e.g. ALL midwives) will commit to a “natural childbirth” at all costs, and to support their rigid ideologies will use “too much force” to deliver the baby when an emergency c-section could be the best option. These are tried and true rants about midwifery practice that lawyers enjoy spewing in the courtroom. Typically, these tired bed-time stories may be delivered to the jury panel by a zealous litigator who is likely to be thoroughly ignorant of professional midwifery education, training, and ethics. Courtroom drama can often outshine the truth.

Expect erroneous facts from attorney websites. Never rely on their statistics and how much money can be made by suing doctors and midwives. Unfortunately, the uninformed public may buy it all. This is what maternal care providers are up against. Understand that attorneys’ motives are mostly financial, not to save babies. If babies and their mothers weren’t subject to harm, attorneys couldn’t sue midwives and become wealthy. The bogus nature of their ads serve one purpose; monetary gain. Altruism is rarely part of the picture. Absolutely nothing that lawyers may say or do will help make babies or mothers safer. Medical-legal awareness and dedicated care from doctors, midwives, and nurses will.

Next: Informed Consent, Vaginal Breech Birth Training and Credentialing

Matzus Law – Trusted.Proven.Results. https://www.matzuslaw.com/

Levin & Perconti. Attorneys At Law. https://levinperconti.com/birth-injury/breech-birth/

Can You File a Birth Injury Lawsuit Against a Midwife? Ankin Law – Chicago. Https://ankinlaw.com/can-you-file-a-birth-injury-lawsuit-against-a-midwife/

ARFAA Law Group. Breech birth Injury. Page 1. https://www.arffaalawgroup.com/breech-birth-injury-.html

https://www.midwivesontrial.com

Midwives and Vaginal Breech Delivery - Part III

Vaginal Breech Birth Training, Hospital Credentialing, and Informed Consent

Midwifery and Vaginal Breech Delivery - Part II