Can Medical Negligence Lead to Preterm Birth?

Having a baby should be an exciting time for a mother. While many babies are delivered without a problem, there are also many instances where there is a problem or issue during the pregnancy, leading to an early delivery. Having a preterm birth is a scary time, as it can be dangerous for the baby. The infant’s body may not be fully developed, leading to complications for it later in life. Far too often, the baby may not even survive long after the birth.

This tragedy, while sometimes unavoidable, may have been prevented had the doctor or medical team acted appropriately or provided necessary care. If you are pregnant, whether it’s your first time or your seventh, it is important to know the risk factors that lead to preterm birth, and what to be on the lookout for during your pregnancy.

What is a preterm birth?

According to the World Health Organization:

Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age:

• Extremely preterm (less than 28 weeks)
• Very preterm (28 to less than 32 weeks)
• Moderate to late preterm (32 to 37 weeks)

In 2020, over 13.4 million babies were born prematurely, exceeding one in 10 births. Tragically, about 900,000 children died in 2019 due to complications of preterm birth, with survivors often facing a lifetime of challenges like learning disabilities and sensory impairments. Globally, prematurity is the leading cause of death in children under five, with stark survival rate disparities. In low-income settings, half of infants born prematurely face high mortality due to a lack of basic care, while almost all survive in high-income countries. Middle-income countries experience a growing burden of disability among preterm survivors due to suboptimal technology use. Addressing these disparities is crucial for improving global preterm birth outcomes.

What causes preterm births?

Premature birth often lacks a precise cause, but certain factors can heighten the risk. Past and present pregnancy-related risk factors include carrying twins, triplets, or multiples, a short interval of less than six months between pregnancies (ideally waiting 18 to 24 months is recommended), assisted reproduction treatments like in vitro fertilization, and a history of multiple miscarriages or abortions.

Health-related risk factors involve issues with the uterus, cervix, or placenta, certain infections, ongoing health problems such as high blood pressure  (hypertension) and diabetes, preeclampsia, and injuries or trauma to the body. Lifestyle choices, such as smoking, drug use, or heavy alcohol consumption during pregnancy, being underweight or overweight before conception, becoming pregnant at an early age or after 35, and experiencing stressful life events like the death of a loved one or domestic violence, can also contribute to the risk of preterm birth.

Medical malpractice

In some cases, the medical team in charge of your pregnancy may be a cause of your preterm labor. Medical professionals are obligated to provide competent care for both mothers and infants throughout pregnancy and childbirth. There are instances where doctors may fall short of this duty, potentially leading to premature births or inadequate care following a preterm delivery. Malpractice may occur if a doctor neglects to observe signs of preterm labor, fails to recommend bed rest for a mother at risk of premature labor, mishandles the treatment of an ineffectual cervix with sutures, neglects to prescribe steroid injections for the baby’s brain and lung development, or omits medications to halt or slow preterm labor. These lapses in care can have serious consequences, highlighting the importance of medical professionals fulfilling their responsibilities diligently.

What are the complications of a preterm birth?

Premature births can lead to both short-term and long-term medical problems for infants. The earlier a baby is born, the higher the risk of complications, often influenced by birth weight.

Short-term complications can include:

• Breathing difficulties due to underdeveloped lungs
• Heart problems like patent ductus arteriosus (PDA) and low blood pressure
• Brain issues such as intraventricular hemorrhage
• Temperature control problems leading to hypothermia
• Digestive problems like necrotizing enterocolitis (NEC)
• Blood problems including anemia and jaundice
• Metabolism challenges resulting in low blood sugar
• Immune system problems leading to a higher risk of infections

In the long term, premature birth may contribute to health issues such as:

• Cerebral palsy
• Learning difficulties
• Vision problems, such as retinopathy of prematurity
• Hearing loss
• Dental problems
• Behavioral and mental health issues
• Ongoing health problems including illnesses, asthma, feeding difficulties, and an increased risk of sudden infant death syndrome (SIDS)

Premature babies are also more likely to experience delays in development and face a higher risk of various health challenges compared to full-term infants. Regular health checkups and monitoring are crucial for addressing and managing these potential complications.

How to advocate for yourself and your baby

While it is important to trust your doctor and/or your medical team, it is also just as important to know when to advocate for yourself. Your worries are valid, and it is your doctor’s responsibility to not only care for you and your fetus’ physical health, but also to take your concerns seriously.

Here are some steps you can take in order to advocate for yourself:

• Find the right provider: Ensure a good fit by assessing communication comfort, feeling respected, and being heard by your healthcare provider.
• Take notes & track data at prenatal appointments: Record important medical data and keep track of your baby’s movements using apps or pen and paper to stay informed and advocate for yourself.
• Ask questions: Come prepared to appointments with questions, request and review your medical records, and ask for the care you need, whether it’s standard or tailored to your preferences. Seek detailed answers by phrasing questions with “what,” “why,” or “how” for better understanding of medical recommendations.
• Know the complicated system: Understand that healthcare professionals operate within a flawed system and may be influenced by implicit bias, conflicting incentives, and fear of litigation. Advocate for what is best for you and your baby, even if it goes beyond standard prenatal care.
• Bring support: Request the presence of a partner, friend, family member, or doula at prenatal appointments for emotional support and advocacy, especially during labor and birth.
• Don’t be afraid to be headstrong: Clearly express your distress, put requests or concerns in writing, and, if necessary, consider changing your medical provider if trust and responsiveness are lacking. Always prioritize your well-being and your baby’s health through self-advocacy. Listen to your inner voice and speak up if something feels off during pregnancy, labor, or birth.

Having a baby, while a joyful and exciting experience, can be frightening and even dangerous if the proper care isn’t given. When you and/or your baby end up injured due to negligence from your healthcare provider, that’s when you need the help of someone who knows how to get you compensation for your suffering.

Please contact Paulson & Nace, PLLC through this contact form or by calling our office.