Expecting parents place enormous amounts of trust in the doctors, nurses and other medical professionals responsible for successfully delivering their babies. Most of the time, health-care providers perform their jobs carefully and handle and timely recognize potential health risks that arise during labor and delivery.
However, occasionally doctors and nurses mishandle or negligently overlook problems that can result in lasting injuries to the baby or mother. Of these medical errors, one of the most distressing is confusion between the mother's and baby's heart rates during fetal monitoring in labor and delivery, which can lead to tragic consequences for the baby, such as brain damage and even death.
Electronic Fetal Monitoring
According to Washington University School of Medicine, electronic fetal monitoring (EFM) was introduced in the 1970s to monitor babies during labor and delivery and to aid in determining whether surgical intervention, such as a cesarean section, is necessary during delivery. EFM entails monitoring the baby's heart rate to catch abnormal heart rate patterns and other signs of fetal distress. The aim of EFM is to reduce the risk of harm from insufficient oxygen delivery to the baby's brain during labor and delivery, known medically as fetal hypoxia or fetal asphyxia, which results in hypoxic ischemic encephalopathy, i.e. brain damage.
Data from the National Center for Health Statistics show that approximately 700 infant deaths occur each year in the U.S. because of reduced oxygen flow during delivery. Fetal hypoxia is not always fatal, and sometimes the baby suffers no permanent damage. In some cases, though, the baby's body is unable to compensate for the lack of oxygen, leading to permanent brain damage.
Therefore, ob-gyn doctors and nurses use EFM to monitor the fetal heart rate for signs of hypoxia. The fetal heart rate must be studied during labor and delivery to determine whether there are any decelerations (slowing of the heart rate) from the normal rate, which at least indicates a need for further investigation into potential fetal distress like hypoxia. Careful monitoring of the fetal heart rate, proper assessment of fetal hypoxia and an appropriate medical response are all necessary to prevent significant birth injuries and the negative consequences of fetal hypoxia or asphyxia.
Maternal and Fetal Heart Rate Confusion
EFM is used in nearly all hospital deliveries. During labor an EFM device is placed around the mother's lower abdomen to monitor the fetal heart rate of the baby. The EFM device is supposed to capture the baby's heart rate. However, a number of instances have been reported when the EFM device captured the mother's heart rate, which mimicked the baby's heart rate during the mother's pushing with contractions. Essentially, the EFM device lost the baby's heart rate and, instead, recaptured the mother's heart rate, which then looked reassuring. If the baby goes into fetal distress while the nurse or doctor falsely believes that all is well because he or she has confused the mother's heart rate as a substitute for the baby's, the outcome can be disastrous.
According to an article by Michelle L. Murray, PhD, RNC, CNS published in the Journal of Obstetric, Gynecologic & Neonatal Nursing, the limitations and proper use of EFM devices must be understood to prevent fetal injury or death during delivery. The recommended practice is for the doctor or nurse to check the mother's pulse in between contractions at least every 15 minutes and compare it to the heart rate displayed on the EFM's digital monitor. If the baby's heart rate has been lost, then the nurse or doctor can adjust the EFM device and regain the baby's heart rate before an unrecognized limitation in the EFM device results in brain damage or death to the baby. Other medical articles have reported this maternal and fetal heart-rate confusion phenomenon.
Although EFM is widely used to monitor for signs of fetal distress and potential hypoxia, it is not infallible, especially when doctors or nurses confuse the maternal heart rate with the fetal heart rate, or when decelerations are not noticed or accurately interpreted. Medical professionals in charge of the care of mother and baby are responsible for careful monitoring of fetal heart rates and for taking appropriate actions when problems arise. If they fail to do so, they may be found negligent and ordered to pay damages in a medical-malpractice lawsuit.
If brain damage or another birth injury to your child resulted from a doctor's or nurse's medical error, including maternal and fetal heart rate confusion, contact a lawyer with experience in medical malpractice cases to discuss any possible legal claims you may have.
