While childbirth is a joyful occasion for families, we sometimes forget how pregnancy and delivery can be a high-risk time for mothers and infants. Careful monitoring and medical care are crucial to a healthy delivery. But even though the United States is a technologically-advanced country, injuries to babies and mothers due to medical mistakes is disturbingly common.
Infants are the most likely to be harmed during the birthing process or after delivery. Statistics show that 7 in 1,000 infants have some form of birth injury, often with severe consequences. The child may have a brain injury that can result in disabilities such as cerebral palsy. Additionally, families can bear a high financial cost due to medical bills for treatment.
The sad fact is many birth injuries, and injuries to mothers during the birthing process, could have been prevented with better care from medical teams. This information was highlighted in an alarming investigation conducted by USA TODAY. Their research suggests that among developed nations, the United States is most hazardous place to have a child.
Blaming the Victim
In their comprehensive study, USA TODAY collected birthing information from hospitals in 13 states for the past 4 years (2015-2018). This data comprised about half the births in the United States. Notably, the government allows hospitals to keep these statistics private, so they are not often seen by those outside the medical industry.
While this research found that problems at most hospitals were low, 1 in 8 hospitals had high rates of childbirth complications for mothers and infants. Of the 1,027 hospitals studied, 120 of them were in this category. These hospitals were fast to blame causes outside of their control, such as mothers having pre-existing conditions, or being low-income individuals.
However, the data showed that patients at these facilities were more likely to have complications no matter their income level, ethnicity or whether or not they were insured. Instead, the study pointed to medical errors as the prime culprit for why mothers and infants were at higher risk.
Several different factors led to these tragic injury and death rates. Among them were medical issues not being diagnosed by hospital staff, or healthcare workers not treating mothers and infants quickly enough when there was a problem. Other issues included medical staff not taking proper precautions, and care being given by doctors who were in training and more likely to make mistakes than professionals.
According to Dr. Elliott Main, the medical director of the California Maternal Quality Care Collaborative (CMQCC), “We all think we’re giving great care and we are treating everybody equally.” Yet he goes on to say, “The data doesn’t support that.”
Uncovering Deeply Hidden Data
Of the 120 problem hospitals that had a high rate of injury and death, 56 of them train OB/GYN doctors and allow them to care for pregnant mothers and infants. An upsetting 22 of those facilities have a history of being given warnings for problems with improper patient care.
While it is important for doctors in training to have experience in hospital settings, their decisions must be monitored carefully. A senior physician needs to oversee any treatment decisions, to assure these young doctors are prescribing the right medications and tests, and recognizing medical problems before it’s too late.
Hospitals with higher rates of complications sometimes did not have experienced doctors closely supervising the trainees. For example, at some facilities a senior doctor did not have to be in the room when someone was giving birth. Instead, they were only required to be available by phone.
Administrators at hospitals with high rates of injuries and even deaths were fast to blame poverty and mothers with complicated medical problems. At the same time, other hospitals in this study who served similar patients did not have the same rate of complications. The study found these facilities had better safety practices, including at least one experienced physician in the building to help with deliveries.
An Ounce of Prevention
Some doctors have realized that one key to better care for mothers and infants is making sure that the medical staff can identify serious problems when a mother is giving birth. Healthcare providers must be educated in the signs that something is wrong with the mother or child that could put either at risk.
Medical teams must also have excellent communication skills. Since so much is happening during the birthing process, some potential problems may be overlooked. Hospitals must train their staff to know important signs of trouble and to be ready to take action.
For example, facilities in California have trained staff to watch mothers with high blood pressure during pregnancy, which can lead to an injury to the mother and her baby. Having the proper procedures and equipment in place to deal with problems like these has already improved the outcomes for countless mothers and infants.
Healing the System
Providing better care also means mending problems in our system that cause medical errors and endanger all patients – not just mothers and newborns.
Miscommunications between doctors, nurses and other members of medical staff at any time during the pregnancy and birthing process can lead to numerous preventable medical errors. Having more doctors and specialists care for each patient means there is a greater chance that pieces of information may be misheard or lost in the flow.
Proper communication is especially crucial when caring for infants, since newborns are vulnerable to injury in a number of ways. For instance, babies are at greater risk for medication errors after they are born. Since they are so small, infants can easily be given an overdose that can lead to serious injury.
We also cannot underestimate the growing problem of physician burnout among health care providers. Burnout affects judgement and decision-making capabilities that can lead to medical errors, including serious birth injuries.
By addressing these larger issues and realizing that care providers who blame the victim are often themselves to blame, we can make repairs to our medical system, so it delivers superior care not just to mothers and infants, but to all patients.
