Medical experts in the fields of obstetrics/gynecology and perinatology (high risk pregnancies) believe that a Cesarean section (C-Section) rate of around 19% of births or deliveries provides the correct balance for the health and safety of mothers and their babies.
Recent data about United States births show that about one-third of deliveries are by C-Section, rather than vaginal births. Some doctors blame the increasing use of health technology in American hospitals for this trend.
One target of these criticisms is continuous electronic fetal monitoring in many hospital labor and delivery wards. Fetal monitoring provides healthcare providers with immediate information about whether there are concerns with a baby’s well-being. The standard of care requires doctors and nurses to be competent in identifying signs that are reassuring versus non-reassuring in fetal monitoring data. Yet, experts agree that the skills of physicians and nurses in interpreting fetal monitoring data widely vary.
Changes in fetal movement
While, of course, no one wants to go through an unnecessary C-Section, I hope that the pushback by some physicians against this life-saving procedure does not go too far.
From my experience as a Houston, Texas medical malpractice and birth injury attorney, I recognize that there are some situations that should immediately grab the attention of any reasonable obstetrician/gynecologist, midwife, or labor and delivery nurse. Sometimes, these require immediate delivery by C-Section for the health of the baby.
One of these conditions is decreased fetal movement. Some women describe it as, “my baby has not been moving as much is normal.”
A decrease in fetal movement can be an indicate that a baby is in distress. Often, it is a sign of placental insufficiency, meaning that the baby may be receiving inadequate oxygen, which can cause irreversible brain injury.
This reminds me of a case that I handled for a delightful young Sugar Land, Texas family whose daughter was delivered by C-Section at a Houston hospital. The mother was a textbook example of excellent behavior during the prenatal period. She went to all of her physician appointments and immediately notified her doctor’s office one day when she noticed that her baby was not moving as much as she normally did.
I was shocked when she told me that the nurse suggested that she drink some orange juice to help wake up the baby, rather than to come in for evaluation. The woman complied with the nurse’s instructions but noticed no change in the field movement pattern. She called back a few hours later and was finally told to come in. By then, though, it was too late.
When she saw her obstetrician/gynecologist (OB/GYN), electronic fetal monitoring showed that the baby was in fetal distress. Oddly, the doctor instructed the parents to go to hospital across town and to wait for her there. Precious time was lost and by the time the doctor arrived and performed a C-Section delivery, the baby had severe, permanent brain damage.
What you can do
It is important for an expectant mother to be familiar with her baby’s pattern of movement in the womb. In many instances, by month seven of the pregnancy, the baby will develop a sleep-wake cycle of about 40 minutes to one hour, comprising 20-30 minutes of sleep and 20-30 minutes of activity. Whatever the normal pattern for the baby is, the mother should take notice of any changes to it.
If woman is concerned but unsure about the fetal movement pattern, in weeks 32-35 of their pregnancy, many OB/GYN and labor and delivery nurses recommend that mothers check for fetal movements by looking for 10 movements in a two-hour.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.