Threat of Malpractice Suits May Lead to Greater Number of C-sections

Concern about malpractice suits has led many doctors to choose repeat cesarean sections, even when vaginal delivery is possible and may be a safer option.

The National Institutes of Health (NIH) reports that obstetricians face more lawsuits and have higher insurance premiums than just about any medical specialty, except neurosurgery. The fear of litigation causes some doctors to choose a C-section as the legally safe option, rather than allow the mother to choose the type of delivery. This infringes on the rights of the mother and possibly puts her in danger, Utah’s Deseret News reports.

C-sections have increased from 5 percent of all births in 1970 to 31 percent in 2007, according to the American Congress of Obstetricians and Gynecologists. Repeat C-sections can be necessary to prevent harm to the mother or child, but a vaginal birth after C-section (VBAC) “avoids major abdominal surgery, lowers a woman’s risk of hemorrhage and infection, and shortens postpartum recovery,” the ACOG says. While the medical community agrees that there are too many C-sections, “doctors don’t have much choice,” Naomi Schafer Riley writes.

Louise Marie Roth, an associate professor of sociology at the University of Arizona says the rising number of C-sections, does not correlate with a rising number of malpractice lawsuits over VBAC, according to the Deseret News. Rather, it is the fear of such lawsuits that prompts many hospitals to turn to repeat C-sections. But these fears, Roth writes, “do not justify subjecting millions of women to unnecessary surgery, which violates medical ethics and pregnant women’s human rights.” The New York Times reports that a New York woman is suing the hospital for forcing her to have a C-section in 2011 for the birth of her third child.  Her bladder was injured during the surgery.

VBAC is successful for 60 to 80 percent of eligible women and saves the mother from going through another surgery. In 2010, ACOG issued guidelines to enable more hospitals to safely allow VBAC. To combat the fear of malpractice suits, there is a clause that allows a doctor to send a patient to another physician if he or she doesn’t feel comfortable with VBAC delivery, according to the Deseret News.