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Fetal Monitors
A Necessary Part of Delivery?
By Teri Brown
In 2006, a young couple from Monroe, Mich., was awarded a $15.8 million verdict as the result of their baby son being inflicted with cerebral palsy due to an error during the final stages of labor. One of the acts of negligence named during the suit was that the fetal monitor had been removed during labor so the mother could go to the bathroom. During this time the baby compressed against the umbilical cord and cut off oxygen, causing the cerebral palsy.
Many doctors, such as Dr. Randy Fink, an OB/GYN in private practice in Miami, Fla., are not willing to take the risk, with either their careers or their patients, even if that pits them against natural childbirth advocates.
"Unfortunately, many of the ideals of Lamaze put us at odds with our patients," Dr. Fink says. "The proponents of a fully 'natural' experience with childbirth would have patients believing that medical science has done nothing to improve maternal and neonatal outcomes. There are parts of the world where the 'natural' childbirth experience results in an infant mortality rate of one in nine, and where one in six moms die in childbirth. Is this acceptable in the United States? Is this possibility acceptable to you? To me, there is only a one-word response: no."
Dr. Fink says that abnormal fetal heart rate tracings are a common reason for instrumental vaginal deliveries and C-sections, but is isn't true that monitoring leads to increased risk of infection. He believes the problem is that doctors have no other way of being reassured that a baby is not in danger during labor, which leads to something called a "standard of care."
"It is convenient to suggest that the 'medicalization' of childbirth, such as fetal monitoring, does not help moms or newborns," Dr. Fink says. "But in the event a baby is born with a problem such as cerebral palsy, no matter how much of a natural experience the patient demanded, the statistics are even clearer that they will ultimately hire a lawyer to sue the delivering clinician. And the first item of business the lawyer will review is the fetal heart tracing."
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