The demand for qualified midwives has grown in recent history as women seek their services for personal and financial reasons alike. What most people are unaware of, however, is that there are different types of midwives and certain risks associated with the choice to have a natural birth at home. It is the responsibility of a midwife to make these risks very clear to the families they serve so they can make informed decisions and take appropriate cautionary measures that may benefit the child if something should go wrong. The Chicago midwife medical malpractice attorneys of Rosenfeld Injury Lawyers believe that everyone has a right to be informed when choosing unconventional methods of medical treatment and the right to compensation when something goes wrong.
Types of Midwives and Licensing Requirements
Not all midwives are created alike, and mothers seeking the services of a midwife need to spend a great deal of time vetting the person they trust with assisting them during and after birth. While many of the people who choose to pursue careers in midwifery are certified nurses, others are able to achieve certification with no nursing education or experience at all. They may receive their education and training while serving in support roles prior to entering a midwife training program.
In Illinois, the two most notable types of midwife are a Certified Nurse Midwife and Certified Professional Midwife. The difference between the two is that a CPM has no medical background and was a direct entry into a midwifery training program. Regardless of whether a midwife is a CNM or a CPM, the duties and goals for the position are identical, which include counselling, educating and assisting expectant parents through their pregnancies and assisting at and after the time of birth.
The primary reason someone would seek the services of a midwife is the desire to have a natural birth with the minimal use of technology or medication. Many women wish to give birth at home, but others are not opposed to having the child in a hospital or clinic so long as they can give birth naturally. There are many things that can go wrong during a natural birth, so easy access to emergency care is essential.
Risk and Liability Concerns over Underground Midwives
CNMs are licensed to practice across state lines and wherever they please due to their medical credentials and experience. They normally operate with access to qualified doctors and have the necessary tools to identify and respond to an emergency. CPMs are not recognized by the State of Illinois, which means they are referred to as underground midwives. Practicing underground makes it extremely difficult to protect both the mother and child in the event of complications.
Underground midwives do not have access to medications, have limited access to insurance reimbursement and rarely work cooperatively with an obstetrician or hospital. All of these disadvantages make selecting a CPM extremely risky, especially considering that they are far less likely to have sufficient liability insurance as well. This means that if they do commit an error, they are less capable of providing compensation to the child and family affected.
How Midwife Malpractice Occurs and Preventative Measures to Take
Some people are under the false assumption that a midwife’s only duty is to assist the mother during childbirth, but a midwife enters a mother’s life and provides support much sooner. They help mothers plan for their births, provide gynecological care and educate the parents to be on how to handle many of the problems they may encounter during labor and after delivery. Another important responsibility is the monitoring of the mother and child for signs of complications and the referral of the mother to a specialist in the event that a natural birth is no longer recommended.
Only ten years ago, just 3% of births were attended by midwives while 10% of today’s births utilize a midwife’s services. More families are choosing to have their children at home or through natural means. The reasons for this vary, but it is suspected that the exorbitant cost of a hospital stay has driven many low income families to seek the services of midwives rather than absorbing the medical costs associated with more conventional delivery methods.
While a midwife provides valuable counselling, education and preventative care, midwives are not doctors and need to be more transparent about the risks that women are taking when they choose to bear children at home without access to emergency care. Some women may be unable to have a natural birth for medical reasons or due to complications throughout the pregnancy. It is the duty of a midwife to assess these risks and know when it is right to defer care back to a hospital or obstetrician.
Following are all of the things that midwives must do to protect themselves and the mothers they serve.
- Obtain the right credentials— since CPMs are not recognized in Illinois, it is practical for those wishing to become midwives to certify as nurses first.
- Screen patients and refer high risk pregnancies to specialists— mothers that are experiencing complications during pregnancy need regular monitoring to ensure that the baby is developing properly and not showing signs of distress. Some medical conditions or procedures can increase the risk associated with natural births. One such example is when a mother has a cesarean section. Vaginal birth following a C-section has many risks that midwives often ignore. Not every mother should be considered as a candidate for a midwife assisted birth, and it is the duty of the midwife to only serve mothers that are fit.
- Inform mothers of risks— there are numerous risks associated with natural births and many of the risks may be specific to the mother’s medical history and situation. If a midwife doesn’t clearly disclose all of the risks, she can be held liable if something goes wrong.
- Monitor the child— mothers determined to have natural births and the midwives assisting them often have tunnel vision, making them so adamant about bringing the child into the world in the desired manner that they don’t consider the needs of the child. There are some clear signs of distress that simply cannot be ignored and a midwife needs to recognize when it is time to defer to someone more qualified to provide emergency care.
- Have and communicate emergency plan— midwives need to not only have an emergency plan in place, but also to make sure that the child’s parents understand the plan. The right midwife will have access to medical equipment and supplies such as oxygen and fetal monitoring equipment. She will also have admitting access to a hospital or an obstetrician on call in case the mother or child is in danger. These are just reasonable and responsible measures to take, regardless of risk factors or how well the pregnancy has progressed.
- Obtain malpractice insurance— doctors are often insulated from liability because they acquire medical malpractice insurance, which is a responsible way to ensure they can provide compensation to those injured under their care. Midwives can and should also obtain enough insurance to cover up to $5 million in liability costs so that they can cover the potential costs of a life-altering injury.
Birth Injuries Associated with Midwife Medical Malpractice
Our Chicago midwife malpractice lawyers often find that the injuries an injured child must live with for his or her entire life due to a birth injury are devastating. In addition to the physical, emotional and mental toll on the child is the unbearable financial burden placed upon the family. The injuries that may result from midwife negligence may include some of the following.
- Cerebral palsy— this developmental and neurological disorder may result from an injury during birth that results in internal bleeding. The bleeding itself is not the cause, but the body releases bilirubin in response, which an infant’s liver is unable to filter and regulate, resulting in brain damage. Jaundice is the most obvious indicator that a child is at risk, but since midwives do not have access to the medications available at a hospital, there may be a delay in treatment.
- Developmental delays— if the child was in distress at any point during labor, he or she may have been deprived of oxygen for an extended period of time. This can result in significant brain damage, which may not be exhibited until the parents notice that the child’s cognitive development is lagging.
- Cephalohematoma— this condition is defined as internal bleeding between the skull and the membrane that lies beneath. In addition to causing jaundice, it may be an indicator of a skull fracture and could result in anemia or increased risk of infection. Most of the complications are treatable, but additional injuries can result due to a delay in treatment, such as loss of hearing, cerebral palsy and brain damage.
- Postpartum hemorrhage— there are numerous causes of excessive bleeding after birth and it is important for doctors to act quickly both to determine the cause of the bleeding and prepare for a blood transfusion, but what happens when there isn’t a doctor present? If the mother does not receive medical care quickly enough, she may die of blood loss. She is also at an increased risk of infection during this time.
How our Experienced Midwife Malpractice Lawyers Can Help
If you or your child has been injured due to midwife negligence or you lost your loved one because of the reckless actions of your midwife, we may be able to help you. Rosenfeld Injury Lawyers is a leading law firm serving Chicago and has helped thousands of families secure the compensation they needed to provide for a child whose life altering injuries were the fault of a negligent medical professional.
Contact us today to arrange a free consultation with one of our Chicago midwife medical malpractice attorneys so that we can review the details of your claim and investigate even further. Once we have the information we need, we can let you know more about your legal options and answer any questions you have about the legal process. We can also assure you that if we are unable to secure damages on your behalf, our services will cost you nothing.