Obstetricians (OB/GYNs) sometimes recommend induction of labor when a pregnant woman reaches full term but hasn’t delivered her baby.
What is induction of labor?
Doctors and labor and delivery nurses induce labor by injecting Pitocin (a manufactured form of oxytocin) into an intravenous (IV) line. Pitocin causes the uterus to start contracting and often succeeds in getting active labor underway before it would’ve happened on its own.
Sometimes induction of labor is largely for convenience, but there are a variety of medical reasons why a physician may recommend it:
• Post-term pregnancy. Most OB/GYNs will recommend induction of labor if it hasn’t started within one to two weeks after the due date.
• Water breaks. When there’s premature rupture of membranes but labor doesn’t begin, that can be a reason for inducing labor.
• Intrauterine growth restriction. During prenatal care, doctors and nurses estimate the baby’s length and weight. If the baby’s estimated weight is less than the 10th percentile, the doctor may recommend induction of labor.
• Chorioamnionitis. A uterine infection.
• Oligohydramnios. Abnormally low amniotic fluid.
• The mom has gestational diabetes.
Pitocin and inducing labor linked to baby’s brain injury
A Texas woman had reached full term in her pregnancy. Let’s call her Miranda.
Miranda had regular prenatal care with an obstetrician, who recommended elective induction of labor. There were no particular medical concerns.
Miranda set up an appointment with the labor delivery unit of the hospital and was admitted. The nursing staff connected her to electronic fetal monitoring (EFM) by positioning two belts with sensors around her abdomen.
EFM equipment allows real-time tracking of the fetal heart rate and the mom’s pattern of uterine contractions. This information can provide important insights about the health of the baby and whether there’s a need to expedite delivery, including converting from natural delivery to a cesarean section (C-Section).
After the labor and delivery nurses got Miranda situated in her room and EFM going, they started the Pitocin IV. It didn’t take long for uterine contractions to begin.
As labor got underway, the EFM showed that Miranda’s uterus was contracting too quickly, with not enough rest in between contractions. This is called hyperstimulation or tachysystole. This can be a dangerous condition requiring immediate medical intervention because it can make it difficult for the baby to get enough oxygen.
The nursing staff was aware of Miranda’s overly-brisk uterine contractions but didn’t communicate this important finding to her doctor. Thus, her labor continued in this dangerous pattern of contractions.
The next concerning finding was late decelerations of the fetal heart rate. A deceleration is a significant drop in the fetal heart rate after a uterine contraction. Late decelerations are typically a sign of insufficient blood flow to the baby, which sets up fetal acidemia and brain injury.
Despite being aware of several late decelerations on EFM, the labor and deliver nurses once again didn’t notify Miranda’s physician.
When Miranda’s OB/GYN eventually re-evaluated her and saw the EFM strip, he ordered an emergency C-Section. By then, though, it was too late. Miranda’s baby was born with a profound hypoxic brain injury.
Sadly, the EFM provided the information about low blood flow and oxygenation to the baby. That means that this tragedy could’ve been avoided if the nurses had communicated the critical information. When there are clear signs of fetal distress, obstetrical experts know that the standard of care requires delivering the baby as soon as possible.
If your baby has been seriously injured by poor labor and delivery care in Texas, contact a top-rated, experienced Texas medical malpractice attorney for a free strategy session about your potential case.