Delayed Emergency C-Section
There are certain cases where delivery must take place immediately because of the presence of a dangerous maternal or fetal health issue. There are standards laid out for when this happens, and doctors must follow these standards. If an emergency C-section takes longer than 5 to 30 minutes to perform (depending on the circumstances) or if doctors prolong a labor for longer than is reasonable, it increases the risk of birth injury. Immediate C-section delivery is often necessary in cases of fetal distress, placenta previa, uterine rupture, cord prolapse, placental abruption and failure to progress in labor.
Generally, emergency C-sections must be completed in 30 minutes or less to keep the baby safe. In many of the cases we see, the C-sections are not completed in time and a birth injury or brain damage occurs. If your emergency C-section was delayed and your baby has a birth injury, contact Reiter & Walsh ABC Law Centers to learn more about how we can help.
Sometimes, doctors fail to call an emergency C-section despite obvious fetal warning signs. Other times, an emergency C-section is ordered but the hospital or birthing facility is ill-prepared and it occurs too late. Poor medical decisions and delays can lead to a baby born with significant problems such as cerebral palsy, seizure disorders, periventricular leukomalacia (PVL), intellectual disabilities, developmental delays, hydrocephalus, Erb’s palsy, and other birth injuries.
When Are Emergency C-Sections Necessary?
It is estimated that about 1 in every 159 deliveries today is an emergency c-section. There are many critical situations that can occur during labor and delivery that require an emergency C-section. The most common include:
- Fetal distress. This is probably the most common reason and it occurs when the baby’s heart rate drops too low or stays at a low rate for a long period of time. This can happen from an epidural, a sudden drop in the mother’s blood pressure, or uncontrolled bleeding in the mother from placental problems such as placental abruption (where the placenta separates from the uterine lining and interferes with the baby getting oxygen). Fetal distress can be a sign of oxygen deprivation (hypoxic ischemic encephalopathy).
- Placenta previa. This happens when the placenta is low in the uterus and is near or covering the cervix. This can cause hemorrhaging in the mother.
- Uterine rupture. This happens when the uterus tears during labor and delivery. It’s estimated that this occurs in about 1 in every 1,500 births. A uterine rupture can lead to hemorrhaging and a lack of oxygen to the baby.
- Cord prolapse. This happens when the umbilical cord comes out before the baby. Compression from uterine contractions as well as the weight of the baby itself can cut off blood flow to the baby.
- Failure to progress in labor. Sometimes the cervix does not dilate properly or labor slows or stops.
Emergency C-Section Protocol: 30 Minutes from Decision to Incision
In a situation where time is critical and a delay can lead to permanent brain damage or infant death, a rapid response by medical staff is imperative. The American College of Obstetrics and Gynecology generally recommends that most emergency c-sections are performed within 30 minutes of the time that the decision for the surgery is made. It is also recognized, however, that there are certain obstetrical emergencies like cord prolapse, uterine rupture and bradycardia (slow heart rate, usually below 60 beats per minute), that require a C-section is performed much sooner than 30 minutes.
But what happens if doctors fail to perform an emergency C-section within 30 minutes? Or worse, what if they fail to even recognize signs of fetal distress on fetal monitors? If birth injuries occur, the medical professionals should be held responsible for their medical errors.
Award-Winning Cerebral Palsy Lawyers Helping Children with Birth Injuries
From our location in Michigan, Reiter & Walsh, P.C. represents clients all over the United States. Within the Great Lakes region, many of our clients live in Detroit, Grand Rapids, Cleveland, Toledo, Milwaukee, Columbus, and other cities across Michigan, Ohio, and Wisconsin. Beyond the Great Lakes region, we have assisted clients in Tennessee, Arkansas, Mississippi, Washington D.C., Texas, Pennsylvania, and other states. Our award-winning birth injury law firm has handled numerous birth injury and delayed C-section cases, and we have over 100 years of joint experience in this complex area of law. Unlike other firms, birth injury is our sole focus.
To begin your free case review with our birth injury attorneys and nurses, please contact Reiter & Walsh, P.C. at:
Free Case Review | Available 24/7 | No Fee Until We Win
Video: Delayed C-Sections, Birth Injuries and Cerebral Palsy
Watch a video of Michigan cerebral palsy lawyers Jesse Reiter and Rebecca Walsh discussing how delayed emergency C-sections can cause prolonged birth asphyxia and birth injuries such as cerebral palsy.
Related Articles and Blogs from Reiter & Walsh ABC Law Centers
- “Emergency C-sections: When 30 minutes isn’t fast enough.”
- “C-section is safest delivery method for preterm breech infants.”
- Freeman RK. Problems with intrapartum fetal heart rate monitoring interpretation and patient management. Obstet Gynecol 2002; 100:813.
- WALKER N. The case for conservatism in management of foetal distress. Br Med J 1959; 2:1221.
- Benson RC, Shubeck F, Deutschberger J, et al. Fetal heart rate as a predictor of fetal distress. A report from the collaborative project. Obstet Gynecol 1968; 32:259.
- Young BK. Monitoring the fetal heart: a continuing controversy. Obstet Gynecol Surv 1995; 50:699.
- American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol 2009; 114:192.
- Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev 2006; :CD006066.
- Graham EM, Petersen SM, Christo DK, Fox HE. Intrapartum electronic fetal heart rate monitoring and the prevention of perinatal brain injury. Obstet Gynecol 2006; 108:656.
- Thacker SB, Stroup DF, Peterson HB. Efficacy and safety of intrapartum electronic fetal monitoring: an update. Obstet Gynecol 1995; 86:613.
- Vintzileos AM, Nochimson DJ, Antsaklis A, et al. Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth. Am J Obstet Gynecol 1995; 173:1021.
- Larma JD, Silva AM, Holcroft CJ, et al. Intrapartum electronic fetal heart rate monitoring and the identification of metabolic acidosis and hypoxic-ischemic encephalopathy. Am J Obstet Gynecol 2007; 197:301.e1.
- MacDonald D, Grant A, Sheridan-Pereira M, et al. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. Am J Obstet Gynecol 1985; 152:524.
- Vintzileos AM, Nochimson DJ, Guzman ER, et al. Intrapartum electronic fetal heart rate monitoring versus intermittent auscultation: a meta-analysis. Obstet Gynecol 1995; 85:149.
- Nelson KB, Dambrosia JM, Ting TY, Grether JK. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Engl J Med 1996; 334:613.
- Phelan JP, Kim JO. Fetal heart rate observations in the brain-damaged infant. Semin Perinatol 2000; 24:221.
- East CE, Brennecke SP, King JF, et al. The effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial). Am J Obstet Gynecol 2006; 194:606.e1.
- Bloom SL, Spong CY, Thom E, et al. Fetal pulse oximetry and cesarean delivery. N Engl J Med 2006; 355:2195.