Medico-legal problems in obstetrics

Obstetrics is a specialty that is widely perceived to be associated with a high risk of litigation. In the UK, it accounts for about 60–70% of the total (malpractice) sum paid by the NHS Litigation Authority (NHSLA) each year. Professionals involved in malpractice claims can become demoralized and the fear of litigation might be deterring young medical graduates from entering the specialty, leading to a recruitment crisis. Patients, and their families, who are involved in a litigation process often experience physical and emotional trauma, which might not be alleviated by financial compensation. During the antenatal period, missing structural abnormalities during obstetric ultrasound and failure to inform the patients of such abnormalities can result malpractice claims. Intrapartum fetal distress, shoulder dystocia and complications of vaginal birth after caesarean section account for the majority of obstetric litigation. Effective communication, team working, documentation, training and education as well as robust risk management strategies can help improve patient care and reduce medico-legal claims.