Pitfalls in our practice: examples from four cases of obstetric litigation

Obstetric litigation continues to rise and maternity claims represent the highest value claims and second highest actual number of clinical negligence claims reported to the NHS Litigation Authority (NHSLA). Between 1st April 2000 and 31st March 2010 there were 5087 maternity claims with a total value of £3.1 billion. The NHSLA in 2012 published ‘Ten Years of Maternity Claims’ which highlighted the areas of practice most vulnerable to such. The five categories that represented the highest value claims were:- cerebral palsy, CTG interpretation, management of labour, Caesarean section and antenatal investigations. The main areas in which care fell below the required standard were:- interpretation of antenatal ultrasound, failure to recognise and abnormal CTG and/or act on it, failure to consider a Caesarean section, failure to perform an episiotomy, failure to diagnose the true extent of a perineal injury, failure to perform an adequate perineal repair, inadequate antenatal counselling for vaginal birth after Caesarean section, and failure to recognise a uterine rupture. Of note was that only 21% of the CTG claims involved ‘high risk’ cases. Below are four examples of successful litigation which highlight some common failings.