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Cesarean Section (C-section) Delivery

Giving birth is often referred to as a miracle, and for good reason. There are a number of things that may go seriously wrong during a pregnancy, or during the labor and delivery stage. When a vaginal birth gets risky or dangerous for the mother or child, doctors may choose to perform a Cesarean section or C-section. This is a method of delivering the baby that involves extracting the child from the mother’s body through an incision in the abdomen. During a C-section surgery, surgeons must cut through the skin, tissue and the uterus to safely deliver the baby.

It is important to remember that a timely C-section may not only save the mother and/or the child’s life, but it may also help prevent certain types of birth injuries – that have the potential to disable the baby for life. If your doctor failed to perform a timely C-section, which resulted in your child suffering birth injuries such as cerebral palsy, Erb’s palsy or brachial plexus injuries, it would be in your best interest to contact an experienced New York birth injury lawyer who will help you secure maximum compensation for your losses.

Why Are C-section’s Done?

A C-section is essentially the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. In some cases, a C-section may even be scheduled ahead of time. In other cases, an unscheduled or emergency C-section may be required due to complications that were not anticipated. The U.S. Centers for Disease Control and Prevention (CDC) estimates that about 32 percent of American women who gave birth in 2015 had a C-section.

C-sections tend to be performed when the risks of delivering the baby vaginally are thought to outweigh the risks of delivering the baby through a C-section. Your doctor may schedule your C-section for a time that is not earlier than 39 weeks of the pregnancy (unless there is another medical reason to do so) and when one or more of the following factors are present:

• You have had a prior C-section or more than one previous C-section. This may significantly increase the risk of your uterus rupturing during a vaginal delivery and creating complications.
• You are carrying more than one baby. The more babies you are carrying, the more likely it is that you will need a C-section.• Your baby is larger than average or very large. This is a condition known as macrosomia. Your doctor is likely to recommend a C-section if you are diabetic or if you have had a previous baby that suffered trauma during a vaginal delivery.
• Your baby is in a breech position, which means your baby is feet-first instead of head-first.
• If you are near full-term and have placenta previa, which is a condition where the placenta is low in the uterus and covers the cervix.
• You have an obstruction such as a large fibroid that would make a vaginal delivery tough or impossible.
• You have a condition known as placenta accrete, which is when the placenta is deeply attached to the middle part of the uterine wall.
• You have umbilical cord complications such as a nuchal cord that is wrapped around the baby’s neck, or a short umbilical cord or a “true knot,” which is a knot in the umbilical cord.

Performing a C-section Promptly

There are steps medical professionals can take to prevent birth injuries. One of the most important steps to take here is to recognize the signs of fetal distress or a risk factor that has the potential to cause such distress. The other critical step is to perform the C-section when fetal distress is imminent or evident. The standard of care dictates that the medical team continually monitors the baby’s heart rate when the mother is admitted to the labor and delivery unit. However, in many cases, team members are not adequately trained when it comes to interpreting the fetal heart rate. We see in numerous instances that a breakdown in communication between the physician and the rest of the team has devastating consequences. For example, the obstetrician may not be reached in time to respond to changes that occur.

When babies are in distress, it may involve a range of issues – from them not being able to get out because they are stuck in the birth canal or because they lack sufficient oxygen. A lack of oxygen may cause irreversible brain damage. If a baby’s distress cannot be remedied right away, the physician should make the call to perform an emergency C-section delivery. If the distress is severe and the baby cannot be safely delivered through vaginal birth, a C-section must be quickly performed. Getting the child out of the womb as soon as possible is the only way to give him or her oxygen as well as any other treatment that is necessary to prevent or minimize injury or harm.
It is essential that when such a critical situation arises, the hospital has the capability to perform an emergency C-section. Sometimes, the doctor or staff members are too slow to react or the hospital is understaffed. These delays may cost the baby his or her life, or it may result in debilitating birth injuries.

Obstetricians must be able to recognize when a C-section is needed. Often, we see doctors try to push forward with a vaginal delivery even when there is fetal distress. When doctors know that a baby must be promptly delivered, they induce labor with drugs such as Pitocin or Cytotec in an effort to speed up the process. However, these drugs may cause contractions that are strong and occur at shorter intervals causing the baby to be further deprived of oxygen. A vaginal delivery may get even riskier when the physician attempts to extract the baby using forceps or vacuum extractors. This may once again exacerbate oxygen deprivation and cause other serious injuries and disabilities such as traumatic brain injuries, Erb’s palsy or brachial plexus palsy.

Types of Birth Injuries that may Occur

During a difficult labor and delivery, there is the potential for a number of complications to occur. Studies show that a C-section can help prevent some of these complications and birth injuries. A recent study published in the journal Public Library of Science (PLOS) Medicine concluded that women who have C-sections have a reduced risk of having babies that suffer birth injuries such as shoulder dystocia, fractures and hypoxia or lack of oxygen to the brain.

There are a number of birth injuries that may occur when a baby is deprived of oxygen or suffers other types of fetal distress and is not delivered by C-section. Here are some of the common complications and birth injuries we see when doctors fail to perform timely C-sections.

Shoulder Dystocia

This type of condition occurs when a baby’s head is delivered through the vagina, but his or her shoulder gets stuck in the mother’s pelvic bone. This creates issues for both mother and baby. The word “dystocia” means a slow or difficult birth. There are certain well-known risk factors that may lead to shoulder dystocia. For example, if the baby is larger than average, there is more of a chance that the delivery might be difficult.

Other risk factors include if the mother has diabetes or is pregnant with multiple children, if the mother is obese or has gone over the due date, or if the labor is induced. Shoulder dystocia may also occur when there are no known risk factors. This is why close fetal monitoring is critical during labor and delivery. When shoulder dystocia occurs there is the risk of the baby suffering injuries to the nerves of the shoulder, arms and/or hand or suffering from oxygen deprivation.

Hypoxic Ischemic Encephalopathy (HIE)

This is a type of brain damage, which occurs when an infant’s brain does not receive sufficient oxygen and blood. HIE is caused by asphyxia, often, due to a difficult labor and delivery. Some of the common symptoms of HIE include meconium-stained amniotic fluid, low heart rate, poor muscle tone, weak breathing, pale skin or excessive acid in the blood. HIE is usually diagnosed with a CT scan, MRI, echocardiography or ultrasound. Children who have severe HIE may experience developmental delays, cognitive issues, lack of motor skills, neurodevelopmental issues and seizures. Women with diabetes, preeclampsia, cardiac disease and certain infections are at a heightened risk of delivering babies with HIE.

Cerebral Palsy

Cerebral palsy is a disorder that affects the brain. The word cerebral refers to the part of the brain that is affected and palsy means paralysis. This means one part of the brain becomes dormant or paralyzed, which affects motor functions and other bodily functions. Brain damage that leads to cerebral palsy typically occurs during birth. The most common causes of cerebral palsy are when a child has been deprived of oxygen for too long or pulled out forcefully with forceps or a vacuum extractor. The danger is heightened when the mother endures a long and difficult labor. In such cases, delivering the baby by C-section might be the safer option.

Brachial Plexus Injuries

Brachial plexus injury or Erb’s palsy occurs in newborns during a difficult delivery such as with a large baby, a baby that is in breech (feet-first) position or a prolonged labor. It may also happen when a birth becomes complicated, which is why the doctor must decide whether a C-section is the best option. If one side of the baby’s neck is stretched, the nerves of the brachial plexus may get stretched and injuries may occur. Symptoms of a brachial plexus injury or Erb’s palsy include weakness in one arm, loss of sensation in the arm and partial or total paralysis of the arm. Children with Erb’s palsy may be disabled for life.

 

Frequently Asked Questions regarding C-sections

The following section covers a few questions about C-sections as well as on seeking compensation that we are frequently asked by parents and families of children who have suffered injuries at birth. We hope this will help address some of the concerns you may have:

What is a C-Section delivery?

A C-Section is the surgical delivery of the baby. It involves one incision in the mother’s abdomen and another in the uterus. It is a common procedure that is used to deliver nearly one-third of babies in the United States, according to the U.S. Centers for Disease Control and Prevention. Cesarean deliveries are generally avoided before 39 weeks of pregnancy so the child has sufficient time to develop in the womb. Sometimes, however, complications may require a C-section to be performed earlier than 39 weeks.

When is a C-Section necessary?

A Cesarean delivery is typically performed when complications from pregnancy make a traditional vaginal delivery complicated or risky. Sometimes, C-sections are planned early in the pregnancy, but they’re most often performed when complications arise during labor. Some of the common reasons for Cesarean delivery include:

• Developmental issues in the child
• Baby’s head is too large for the birth canal
• Breech birth (when the baby is feet first instead of head first)
• Mother has health problems such as hypertension or heart disease
• Placental complications such as placental abruption or placenta previa
• Issues with the umbilical cord
• Reduced oxygen supply to the baby
• Transverse labor or when the baby is coming out shoulder first

Can a medical malpractice lawsuit be filed over a C-section birth injury?

There are certain circumstances when a C-section birth injury may be viewed as medical negligence. The most often cited instance is when the doctor fails to perform a timely C-section. Doctors are required to properly monitor maternal and fetal signs and keep track of risk factors. They should also constantly look for signs of fetal distress or other complications. If the failure to perform a timely C-section results in birth injuries, then the injured victims and/or their families may be able to seek compensation for the damages and losses sustained.

Can I file a lawsuit after a botched C-section?

If your child suffered injuries during a C-section that was negligently handled, you may be able to file a medical malpractice lawsuit as well. In order to file a lawsuit, it is important to determine if negligence has occurred before, during or after the procedure and whether such negligence caused the child’s birth injury.

If Your Child Has Suffered a Birth Injury

Birth injuries often have lifelong consequences not just for the child, but also his or her family members. Conditions like cerebral palsy require a lifetime of medical care, which can cause significant financial challenges for the families. If you can prove that the injuries during birth were caused by negligence or substandard care, then you may be able to recover financial compensation for these, and potentially other, losses.

The family of a child who has been injured at birth as the result of a doctor or medical team’s lack of proper fetal monitoring or not performing a timely C-section surgery may be able to file a medical malpractice lawsuit. Families of children who suffer disabling birth injuries may be able to seek compensation for damages including, but not limited to, medical expenses, lost future income, cost of rehabilitation including physical and occupational therapy, counseling, cost of medication and medical equipment, permanent injuries, disabilities, past and future pain and suffering, etc. An experienced birth injury lawyer will be able to help gather crucial evidence in your case, present testimony from noted medical experts and help you secure the compensation you need for your child’s future medical needs and quality of life.

If your child has suffered an injury from complications during birth and medical negligence, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.

One of our clients secured a $43,940,000 verdict for a child who was diagnosed with cerebral palsy. The hospital failed to diagnose fetal distress, which led to brain damage and cerebral palsy from lack of oxygen supply to the brain. The delay in diagnosing the fetal distress and ordering a C-section delivery caused the child’s condition. Defense attorneys argued that the child’s injuries were caused by premature birth and that the obstetrical care was appropriate. The $43,940,000 verdict was eventually reduced on appeal, because the verdict was so huge.

In another case, our client obtained a $4,500,000 settlement where the doctor negligently used forceps to deliver a baby cutting oxygen supply to the child’s brain. The infant suffered from cerebral palsy as a result. We were able to prove that a C-section should have been performed, which may have prevented the cerebral palsy from occurring.

We have seen many cases where New York City Health and Hospital Corporation hospitals deliver babies who are born with cerebral palsy or erb’s palsy stemming from negligence and/or medical malpractice in the labor and delivery etc. of the children. The following list identifies some of these hospitals (operated by New York City Health and Hospital Corporation):

• Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000

• Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000

• North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000

• Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000

• Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131 BIGGEST HOSPITAL IN THE WORLD

• Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000

• Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555

• Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000

• Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262

• Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000

• Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000

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