Most births are relatively uneventful. When something goes awry, though, the parents are left to try and make sense of a flurry of medical speak, panicked looks exchanged between staff, and a gut feeling that something bad just happened. The problem is, in the hours and days that follow—especially when a birth injury claim is suspected—it’s impossible to get clarity.
Hospitals ought to provide an explanation in cases where there has been a bad outcome during birth. Not just any explanation, but the right sort of answers that clarify the medical treatment administered and what it means for the baby. Too many families find themselves piecing together information, unsure if their baby has been appropriately cared for or if mistakes were made.
What Parents Are Entitled to Be Told
Parents are entitled to know what happened after a complicated delivery. Not parents expecting every birth to go as planned; even with good quality medical care, birth can be unpredictable. However, when things take a turn for the worse, parents have the right to know what happened next.
When a baby is injured, sent to intensive care, or needs immediate medical assistance, medical staff ought to provide an explanation that makes sense. This should be covered in the birth debriefing meeting. The meeting allows parents to sit with their medical staff team, reviewing what happened and asking questions about the decisions that were made.
Some hospitals automatically offer this meeting after complicated birth experiences, while others require parents to ask for it. Either way, the meeting should provide explanations of significant happenings and medical staff decisions and insight into what could have been done differently (or not done at all) in case of errors.
What too many parents face, though, is not a proper meeting with the people who assisted during the birth, but a rushed and defensive debriefing meeting that sheds little light on what happened. Parents who have a gut feeling that they are not getting all the information often battle with wondering if this is their trauma and grief resurfacing or if it’s because something really went awry.
What Should Be Happening in the Days Following an Injury
In the event a birth injury occurs, certain steps need to be followed.
Most hospitals do have protocols regarding serious incidents that need to be reported. Parents should be informed if this is the case and if the hospital will undergo an investigation. Serious incident investigations include internal hospital investigations into whether the care the baby received was appropriate.
Each NHS Trust has a slightly different way of conducting these investigations. They are most commonly completed by a team of clinical staff with experience in investigating and managing risks. The investigations usually involve checking the medical records and interviewing staff who were involved in the incident. In some cases, outside expertise is also consulted. Parents should hear updates regarding the progress of and findings from the investigations.
If weaknesses in the quality of care are found during the investigations, parents should be thoroughly informed regarding what they entail and what the hospital plans on doing to improve the situation. The cold hard facts are that investigations are not always completed. Too many parents go months without hearing anything.
Others receive vague letters that do not address anything significant. When serious injuries have occurred and parents need accurate information, consulting with specialists who deal with Birth Injury Claim cases will ensure parents are given proper answers.
What Questions Should Parents Ask
There are a few questions that are often asked after these incidents.
How was the baby’s heart rate monitored? Was there a quick response? Did the staff manage to intervene on time? If staff did use any tools (forceps or vacuum extraction), did they implement them correctly? Was there another way to assist with the delivery? Did someone drop the ball?
If babies were born with injuries due to a lack of oxygen, there are relevant questions that need answers regarding how long they were without it. This does matter because the length of time may determine if the injury is seen as expected or not.
When babies are born without oxygen (hypoxia), timing is everything. Parents should be informed how long it took for medical assistance to arrive and which interventions were performed to assist the baby. Then there is another group of questions that parents should be informed about in instances where there has been shoulder dystocia during delivery (when the baby’s shoulders are stuck in the birth canal).
In cases like this, certain techniques should have been applied in a specific order within an exact time frame. Parents should be made aware of this, and whether medical staff adhered to it. This also applies to any emergency birth situations. Parents should know what went wrong during the birth and how the staff cared for the situation at hand.
When Medical Records Don’t Match Memories
One of the more uncomfortable things that happens to parents after such a traumatic event is reading their medical history and discovering that there were some things recorded that were not how they remembered it. The times of incidents during their delivery do not align with their memories, conversations they think they had did not happen, and interventions they thought were delayed were completed timeously.
Sometimes memory can fail people during traumatic moments; it’s just human nature to block out the bad memories of particular situations. Other times, it points to something much more worrisome. Things may have been recorded retrospectively or incorrectly. For parents who do find something amiss in their medical records, it can prove invaluable to have it evaluated independently.
Experts who handle these types of cases can read through hospital medical records without any bias. They can highlight areas where there is missing documentation, as well as anything unusual that occurred while parents were under medical care.
These experts can also inform parents if they received appropriate care even though they may not remember every intervention administered.
More Than Just Negligence: Is There a Difference Between Complications and Negligence?
Not every difficult birth results in negligence. Babies can be injured, although they received quality care. Some cannot be avoided, no matter what is done to assist the baby with their delivery.
Negligence occurs when the medical treatment the patient received does not meet expectations under normal circumstances. It may involve failure to monitor, detect abnormalities, delays in managing issues, etc. When this happens, the question is whether a reasonable medical practitioner would have done anything differently, and the answer is typically found when independent assessments of medical records are done.
Parents may feel guilt, constantly wishing that they had done something differently to change the outcome of their baby’s incident. Sometimes the honest answer is that even with appropriate medical treatment, their baby would still have sustained their injury. Other times, independent assessments shed light on failures that would have made a difference in the outcome.
What Should Happen If No Information Is Given
Some hospitals provide exceptional care. Other staff members might not be as good at delivering bad news. Sometimes, situations are so complicated that even excellent communication leaves families with unanswered questions.
When parents are not given adequate answers (whether due to mistakes or a defensive approach by those involved), there are steps parents can take.
Parents have the right to be given copies of all their medical records (the Data Protection Act actually enforces this). They should be given time to make sense of their baby’s medical diagnosis. Parents can ask for second opinions regarding the treatment administered to their babies. They can also contact patient advocates to acquire knowledge about what options they have after their baby’s injury. They may also contact their relevant regulatory body for complaints, seek local specialists for help with their babies if they require ongoing care, etc.
For families facing serious long-term challenges due to their injury, parents need answers regarding what happened to their babies, not only to find closure but also to ascertain the resources their babies may need in the future.
In order to get proper answers about what is needed for their baby’s future.
The following three questions must be answered by hospitals: What happened? Was the baby given appropriate care? What does it mean moving forward?
Hospitals should be able to provide accurate answers, not vague ones, as memories are mixed during busy hours following births on these wards. The time taken by hospitals to answer these questions helps parents whose lives will never be the same again reconstruct a new life for themselves, one day at a time, after traumatic incidents like this one.
