A duty of care for a mother
Having a baby is the most wonderful, terrifying, elating and difficult experiences and I speak from first-hand knowledge! I don’t think I have ever experienced such a range of emotions at once. All the time, from the first confirmed pregnancy test to the emergency caesarean section that was ultimately required all I could think of was seeing my child safely into the world. All thought for myself was secondary which is entirely natural. However, as a Mother, you are owed a duty of care too. Of course, all hands are on deck to ensure the safe arrival of your child, but you are also to be cared for and protected.
Carrying a child is no easy feat and take a tremendous toll on the Mother. She should be monitored just as closely as the baby through all stages of pregnancy from first booking, through regular midwifery appointments, to birth itself. Failure to diagnose problems in a timely fashion at any stage can cause great harm to mother and baby. This blog takes focus on Mum and the dangers that she faces and where clinical negligence can have a devastating effect on her.
The dangers that a mother faces
Generally, there are many factors that can increase risk of complications in pregnancy. These include general considerations such as age of the mother, weight, pre-existing medical conditions, amongst other things. Women under the age of 20 carry a significantly higher risk of serious medical complications such as pre-eclampsia, premature birth, hypertension, etc. Women over the age of 35 also carry a greater risk of hypertension, diabetes and cardiovascular disease and pregnancy can exacerbate these conditions. Failure to monitor and treat accordingly can lead to injury and could be negligent.
Common mistakes during management of a mother during pregnancy includes:
- Failure to monitor mother’s observations correctly, such as blood pressure, urine output, general condition
- Failure to diagnose and treat infection
- Failure to manage complications
- Failure to diagnose and treat abnormalities
There are many complications through pregnancy that can severely effect the Mother. Failure to treat these correctly can not only lead to a period of injury for her that is over and above that which she would have suffered in any event, but can lead to infertility and even more severe outcomes. I cannot list them all here, but will briefly touch on a few.
Ectopic pregnancy is a real danger and failure to diagnose this in a timely fashion can lead to devastating consequences for the mother. An ectopic pregnancy occurs when a fertilized egg fails to attach to the uterus lining, but attaches elsewhere, usually in the fallopian tube. This pregnancy cannot proceed normally and if left in situ, the growing tissue can cause severe results. The longer this is left without treatment, the greater the chance that the fallopian tube will rupture leading to long term damage to fertility.
Infection during pregnancy should also be very quickly diagnosed and treated. Not only can the infection cause problems with the development of the baby, it puts a lot of strain on the mother. Failure to diagnose this in good time can lead to development of organ failure and other life-threatening complications.
Gestational diabetes is a condition that should be identified and monitored very carefully during pregnancy. There are risk factors that can be identified early such as high BMI and diabetes in the family. A glucose tolerance test should be carried out if there is an indication that this would be a factor. Most women with this can have normal pregnancies, but this does increase the risk of complications such as large babies (which will require assisted birth), pre-eclampsia, etc. all of which has a great effect on the mother. Failure to identify this condition can be negligent as it could lead to incorrect management later down the line.
One of the most dangerous conditions to mother and baby during pregnancy is pre-eclampsia. This condition causes high blood pressure which can reach dangerous levels to the extent that organ failure is a possibility. During pregnancy, the mother will be monitored at regular appointments. Her blood pressure will be regularly checked and urine tested for protein. Caught early enough, pre-eclampsia can be monitored closely with a better outlook for both mother and baby. Medication can be provided to lower blood pressure. Symptoms such as severe headache, swelling and vomiting should be treated as clear signs that pre-eclampsia is developing, and intervention is needed immediately. The only treatment for the condition is delivery of the baby. At times a difficult decision must be made to protect the mother, i.e. delivery of the baby before it was necessarily ideal to do so but this is necessary to ensure the safety of the mother. Full information must be provided to allow an informed decision to be made as to the treatment.
Hypertensive disorders during pregnancy and pre-eclampsia are the leading cause of maternal complications and mortality worldwide. It is simply imperative that it is remembered that it is not just the baby that needs careful care during pregnancy. Mum is owed a significant duty of care to. Failure to provide reasonable care can lead to devastating consequences.
If you feel that you have been incorrectly managed through pregnancy and this has led to an injury to you, please do contact our specialist team who can assist. Please contact us via our online form or call 0300 303 3629.