Longer Labor and Fewer C-sections – Challenging Conventional Wisdom

During thousands of juror interviews for dozens of cases over the years, we have observed one of the most widespread – almost universal – juror preconceptions is a belief C-sections are a safe, easy alternative to a long, painful labor that can be dangerous for both mother and baby.  Instead of appreciating C-sections as the risky, major abdominal surgeries they are, many jurors considering “bad baby” lawsuits suggest it would be safer to perform a surgical delivery the moment the road to delivery gets even a little a bit bumpy. 

Fortunately, things are starting to change, and recent trends and hard data are providing more ammunition to defend doctors who opt not to perform a C-section – and to reshape juror perceptions that C-sections are a “sure thing.” 

For starters, the American College of Obstetrics and Gynecology (ACOG) and the Society of Maternal-Fetal Medicine recently released new guidelines for how long mothers should labor before undergoing a C-section.  Previously, labor was considered “active” at 4 cm dilation and mothers were only allowed to push for two hours maximum before a C-section was recommended.  Under the new guidelines, active labor doesn’t begin until 6 cm and mothers can push for up to three hours (or more with anesthesia or other pain management).  The reason for this change is simple: Longer labors often produce healthier babies as contractions do their work and squeeze fluid from the baby’s lungs to clear them for their first breath.

There has also been a drastic – and quite recent – decline in the rate of early C-sections (those performed at 37 or 38 weeks gestation for non-medical reasons).  These births are down to just 4.6 percent in 2013 from 17 percent in 2010.  Doctors are increasingly holding off on C-sections until they are medically necessary, in part because there is growing recognition that babies born early have more issues with breathing, feeding and staying warm.

The takeaway is clear: A new norm is emerging in which doctors and medical authorities prefer to allow longer labors and avoid unnecessary C-sections because it provides better outcomes for babies, not just fewer risks for mothers.  This highlights the importance of educating jurors about these trends and helping them overcome decades of conventional wisdom about when a surgical delivery is appropriate.

If you have a birth injury case that could use a new perspective, contact Senior Vice President Claire Luna at 714-754-1010 or cluna@juryimpact.net to find out how we can help.