What Counts as Medical Negligence During Childbirth?

Medical negligence during childbirth occurs when a doctor, nurse, midwife, or healthcare provider fails to deliver the accepted standard of obstetric care, directly causing avoidable harm to the mother or baby. Deviating from the level of care a reasonably competent provider should give during pregnancy, labor, or delivery often falls under birth injury malpractice, which frequently involves negligence, as it is a factor in an estimated 80% of preventable birth injuries in the United States.

As per CDC reporting, 7 of every 1,000 babies are born with birth injuries. It is a staggering number, as approximately 30,000 babies sustain birth trauma every year in the U.S. While not every birth injury stems from medical negligence, when a healthcare professional fails to act and monitor or makes a preventable error, a complication becomes negligence. This page outlines the legal definition of medical negligence in obstetrics, its most common indicators, and what you as a parent should do if you suspect birth trauma caused your child harm.

The Legal Definition of Medical Negligence in Obstetrics

“Medical negligence” and “medical malpractice” are often used interchangeably, meaning the same thing under the law in most U.S. states. Proving either requires satisfying four legal elements: duty, breach, causation, and damages. To win a birth injury claim, all four must be established. If even one element can’t be proven, the case cannot succeed regardless of how serious the injury was.

According to a Coverys insurance study, approximately 40% of birth injury liability claims involve poor management of labor and delivery, making it the single largest category of obstetric negligence. Outlining how important these four elements are, a landmark AHRQ study identified roughly 157,700 potentially avoidable injuries to mothers and newborns in a single year.

In every U.S. jurisdiction, proving negligence requires expert medical testimony. A qualified specialist must confirm that the provider’s conduct fell below the accepted standard of care and that the deviation directly caused the child’s injury.

Here is a breakdown of these elements with examples.

How “Standard of Care” Is Defined in Labor and Delivery

The standard of care is the legal and medical benchmark every birth injury case is measured against. It is defined as what a reasonably competent OB, nurse, or midwife with similar training would have done under the same circumstances, and failing to meet it is the foundation of every negligence claim.

In court, the primary benchmark for standard of care is the American College of Obstetricians and Gynecologists (ACOG) Clinical Practice Guidelines. For example, ACOG’s 2025 guidelines require doctors to check a baby’s heart rate every 30 minutes during early labor and every 15 minutes during active pushing for low-risk pregnancies. For high-risk pregnancies, those checks must happen every 15 minutes and every 5 minutes, respectively.

If a provider skipped those checks and something went wrong, that gap becomes evidence of a breach.

Beyond ACOG guidelines, courts also look at hospital protocols, peer-reviewed medical literature, and a provider’s specialty board certifications to establish what was expected. Importantly, not all hospitals are held to the same standard. ACOG defines maternity care facilities from Level I community hospitals to Level IV specialized centers. As the levels increase, so do staffing requirements and clinical capabilities. A hospital equipped and staffed to handle high-risk births must meet a higher standard than a smaller facility that is not.

What Separates a Complication from Negligence?

Not every birth injury is caused by medical malpractice. Some injuries happen even when doctors and nurses do everything right. However, when a provider fails to respond to warning signs that a competent provider would have caught, it crosses the line from complication to negligence.

The key question is never whether the outcome was bad. It is whether the medical team responded the way a competent provider should have. A complication is an unpredictable event that occurs despite proper care. Negligence is a preventable failure in something a competent provider would have caught, avoided, or responded to differently. Let’s understand some scenarios to help you understand the difference.

What Is Medical Negligence During Childbirth & How Does It Happen?

Medical negligence during childbirth refers to the quality of care that mothers and their soon-to-be-born babies receive. When poor care or lack of attention is provided, severe or fatal injuries can occur, resulting in medical negligence during childbirth.
Obstetric negligence is one of the most consequential and costly categories of medical error in the country. Vacuum-assisted deliveries injure babies at a rate of 59 per 10,000 births according to NIH data, and OB/GYN-related claims accounted for 25% of all medical malpractice payments made between 2009 and 2014 according to AHRQ. Birth injuries also account for 20% of the approximately 20,000 infant deaths that occur in the United States every year, according to the CDC.
Below are the six most common ways medical negligence occurs during childbirth.

Failure to Monitor Fetal Heart Rate

What should happen: ACOG requires fetal heart rate to be reviewed every 30 minutes during early labor and every 15 minutes during active pushing for low-risk pregnancies, and every 15 and 5 minutes, respectively, for high-risk pregnancies.

What goes wrong: Strips are not reviewed on schedule, alarms are ignored, or abnormal tracings are misread and not escalated to the attending physician.

Potential injuries: Hypoxic-ischemic encephalopathy (HIE), cerebral palsy, and seizure disorders.

Delayed Emergency C-Section

 What should happen: ACOG’s 30-minute decision-to-incision standard requires that once an emergency C-section is ordered, the baby must be delivered within 30 minutes.

What goes wrong: Delays occur due to operating room unavailability, understaffing, or a breakdown in communication between nursing staff and the attending physician.

Potential injuries: Permanent brain damage, HIE, and in the most severe cases, death.

Improper Use of Forceps or Vacuum Extractors

What should happen: Forceps and vacuum extractors are only appropriate in specific, well-defined circumstances and must be used by trained providers following established safety limits, including the vacuum’s pop-off pressure threshold.

What goes wrong: Providers apply excessive force, exceed the vacuum’s pop-off pressure limit, or switch from one instrument to the other after a failed attempt.

Potential injuries: Skull fractures, intracranial hemorrhage, and permanent facial nerve damage.

Mismanagement of Shoulder Dystocia

What should happen: When a baby’s shoulder becomes lodged behind the mother’s pubic bone, providers must immediately follow established emergency protocols, including the McRoberts maneuver, suprapubic pressure, and the Gaskin maneuver, in the correct order.

What goes wrong: The provider applies excessive downward traction on the baby’s head instead of following protocol, or fails to call for additional help in time.

Potential injuries: Brachial plexus damage and Erb’s palsy.

Failure to Recognize and Respond to Preeclampsia

What should happen: Providers must monitor blood pressure and urine protein levels regularly throughout pregnancy and labor, and act decisively when warning signs (elevated blood pressure, proteinuria, or persistent headaches) are present

What goes wrong: Warning signs are missed or dismissed, and timely delivery or treatment is not initiated when the condition becomes severe.

Potential injuries: Eclampsia causing maternal seizures, placental abruption, and severe fetal distress

Pregnancy & Medical Negligence

Medical negligence can happen before labor and delivery too. Pregnant mothers receive routine care and ultrasounds in the 40 weeks leading up to the birth of their baby. During that time, doctors monitor the growth and development of the baby and watch for signs of abnormalities. Failing to do so is a breach of duty and cause for negligence.
Listed below are some specific screening and management failures that can occur during pregnancy and directly increase the risk of birth injury risk factors at delivery.

• Failure to screen for or manage gestational diabetes: Unmanaged gestational diabetes causes babies to grow larger than normal known as macrosomia. The baby’s size increases the risk of shoulder dystocia during delivery, which can lead to permanent nerve injury if not handled correctly.
• Failure to diagnose preeclampsia during prenatal visits: Preeclampsia is detectable through routine blood pressure and urine protein checks at every prenatal visit. When providers fail to diagnose it early, the condition can escalate into a life-threatening emergency for both mother and baby by the time labor begins.
• Failure to identify fetal growth restriction: Missing the signs of fetal growth restriction leaves a compromised baby at serious risk of oxygen deprivation during labor.
• Failure to recommend folic acid supplementation: The CDC confirms that folic acid supplementation reduces the risk of neural tube defects by up to 70%. Failing to advise this simple, low-cost intervention during early pregnancy is a recognized and preventable standard of care failure.
• Medication errors during pregnancy: Some medications are known to cause birth defects when taken during pregnancy. Prescribing them such drugs to a pregnant pateint or failing to warn them about risks is a clear breach of the standard of care.
• Failure to order timely ultrasounds: When providers delay or skip recommended ultrasounds, dangerous conditions, like placenta previa and umbilical cord abnormalities, go undetected until they become emergencies during labor and delivery.

Medical Negligence After Delivery

Medical negligence can happen even after the baby is born. The hours and days following delivery are a critical window. If doctors fail to do the proper test after delivery or do not give mothers the required medical attention, that can also be considered medical negligence. Doctors must check for issues with babies after delivery, like jaundice, blood loss, oxygen levels, and blood type, and check the mother for any postpartum complications.

Here are a few post-delivery negligence scenarios that can happen.

• Failure to initiate therapeutic hypothermia for HIE: According to established AAP and NIH standard, brain cooling therapy must be started within 6 hours of birth for babies showing signs of HIE. Missing this reduces the baby’s chances of recovery and can lead to more severe, permanent brain damage.
• Failure to monitor and treat neonatal jaundice: Jaundice is common and easily treatable when caught early. When bilirubin levels are not monitored and treated in time, jaundice can progress to kernicterus or permanent brain damage. AAP classifies it as a “never event” because it is entirely preventable.
• Failure to resuscitate properly: Newborns who are not breathing at birth require immediate, skilled resuscitation. Delayed intubation or incorrect ventilation in those first critical minutes can cause oxygen deprivation serious enough to result in permanent brain damage or death.
• Failure to monitor the mother for postpartum hemorrhage or infection: Postpartum hemorrhage and infection are leading causes of maternal death in the U.S. Failing to identify and treat either condition in time is a recognized, preventable standard of care failure.
• Missing signs of neonatal sepsis: It requires urgent antibiotic treatment. When early warning signs are missed or dismissed, the delay can result in permanent organ damage or death.
• Failure to perform newborn metabolic screening: Skipping or delaying these tests allows treatable conditions to go undetected, causing irreversible harm that a simple blood test could have prevented.

Talk to a birth injury lawyer if your child has suffered a birth injury from medical malpractice. We can help you get compensated for personal and financial losses.

Who Can Be Held Responsible for Birth Injury Negligence?

In a birth injury case, more than one party can be held legally responsible, and identifying every liable party is one of the most important things a birth injury attorney does.

• The attending OB/GYN carries primary responsibility for clinical decisions made during labor and delivery.
• Labor and delivery nurses can be held liable for failing to monitor fetal heart rate, failing to escalate concerns to a physician, or making medication errors.
• Anesthesiologists can be liable for epidural errors or delays in administering anesthesia for an emergency C-section.
• Midwives, both certified nurse-midwives and lay midwives, are held to the licensing standard applicable to their certification level.

What’s more, hospitals are frequently named as defendants under two legal doctrines. Respondeat superior holds a hospital liable for the negligent acts of its employees. Corporate negligence holds the hospital independently liable for understaffing, inadequate training, or policy failures that created the conditions for harm.

What Injuries Result From Negligence?

Birth injuries caused by medical negligence range from treatable conditions to those requiring lifelong care. Birth injury lawyers can help identify negligence on behalf of doctors and other medical staff to determine what happened and who is responsible.

Many factors can cause a birth injury. For this reason, our top-rated birth injury lawyers represent all types of birth injuries, including and not limited to the following:

• Cerebral palsy: A permanent movement and muscle disorder most commonly caused by oxygen deprivation during labor and delivery.
• Hypoxic-ischemic encephalopathy (HIE): A brain injury caused by inadequate oxygen or blood flow to the baby’s brain during or immediately after birth.
• Erb’s palsy and brachial plexus injury: Nerve damage to the shoulder and arm caused by excessive pulling or traction on the baby’s head during delivery.
• Intracranial hemorrhage: Bleeding inside the skull most commonly caused by the improper use of forceps or vacuum extractors.
• Skull fractures: Breaks in the baby’s skull caused by excessive instrument pressure applied during an assisted delivery.
• Spinal cord injuries: Damage to the spinal cord resulting from improper handling of the baby or a difficult breech extraction.
• Kernicterus: Permanent brain damage caused by severe jaundice that was not identified and treated in time after delivery.
• Facial nerve paralysis: Loss of movement on one side of the baby’s face caused by forceps pressure on the facial nerve during delivery.

How Many Birth Injuries Are Caused by Negligence Each Year?

Birth injuries are far more common and preventable than most families realize. The CDC reports approximately 30,000 babies sustain birth injuries annually in the United States, roughly 7 per 1,000 live births. Of those, an estimated 80% are classified as moderate to severe, and medical and legal literature suggests that up to 80% of all birth injuries are preventable with proper obstetric care.

A study by the Agency for Healthcare Research and Quality (AHRQ) identified approximately 157,700 potentially avoidable birth-related injuries in a single year alone. Birth injuries also represent a leading cause of infant mortality, accounting for for an estimated 20% of the roughly 20,000 infant deaths that occur in the U.S. annually. Thus, making them the 4th leading cause of infant death according to CDC data.

On the legal side, approximately 20,000 medical malpractice lawsuits are filed each year in the United States, with birth injury cases representing a significant portion of those claims. The average birth injury settlement exceeds $1 million, reflecting the lifelong medical, developmental, and financial consequences these injuries impose on affected families.

Hire a Birth Injury Lawyer in the United States

After a birth injury, don’t suffer because of a medical professional’s mistake. Get the compensation that you need to care for your baby by filing a claim with a birth injury lawyer from the Birth Injury Lawyers Group. We are ready to win your case, no matter how complex.

We wish to make this time a little easier for families as they navigate through newborn life and traumatic birth injuries. Rely on us for legal advice and to increase your chances of winning a settlement post-delivery.

Get started today and contact us to schedule a free legal consultation. We can help you determine if you have a claim for compensation after a birth injury in the United States.

Frequently Asked Questions

Are all birth injuries caused by medical malpractice?

No, not every birth injury occurs due to medical malpractice. Natural causes, unavoidable incidents, and complex births can cause birth injuries not stemming from malpractice. They can happen even when the accepted standard of care is given.

What is the difference between medical negligence and medical malpractice?

Medical Negligence: A legal term for common and general oversight causing injury. E.g., a healthcare professional causes harm due to unpredictable or unpreventable circumstances.

Medical Malpractice: A specific legal form of negligence. E.g., a preventable injury caused by a healthcare professional who didn’t follow proper guidelines or protocols.

How do I know if my child’s birth injury was caused by negligence?

Common indicators of birth injury caused by negligence include low Apgar scores, delayed response, neglected fetal distress, tools’ misuse, physical trauma, neurological problems, respiratory issues, and feeding difficulties, among others.

Who can be held liable for a birth injury — the doctor or the hospital?

Both the doctor and the hospital can be held liable. Doctors are responsible for clinical decisions during labor and delivery. Hospitals can be held under vicarious liability for their staff’s negligence and independently if they failed to hire qualified personnel or maintain safe equipment.

What types of compensation can I receive for a birth injury caused by negligence?

Families can recover economic and non-economic damages. Medical bills, therapy, lifetime care costs, and assisted devices come under economic damages. Emotional distress and pain and suffering comprise non-economic damages. In cases involving serious conditions like cerebral palsy, hypoxic-ischemic encephalopathy (HIE), or periventricular leukomalacia (PVL), economic damages can extend across the child’s entire lifetime, generally not subject to state caps.

How long do I have to file a birth injury lawsuit?

1-3 years is the timeline in most states from the date of injury or discovery to file a birth-injury lawsuit. Statutes of limitations vary state to state, as some states allow until a child is 18 or 19. You should consult an experienced birth injury lawyer to learn the specific timeline in your state. Missing the deadline permanently ends your right to sue and seek compensation.

Can I still file a lawsuit if my child’s birth injury was not diagnosed until years later?

Yes, in many states, because the discovery rule allows the filing deadline to begin on the date of diagnosis rather than the date of birth. The discovery rule is important for conditions like cerebral palsy that may not be identified until 12 to 18 months of age. Not every state offers this exception, so legal advice must be sought immediately after diagnosis.

How much does it cost to hire a birth injury lawyer?

Nothing upfront. Birth injury lawyers work on contingency, meaning they only get paid if you win. Fee compensation is taken from the final settlement and the percentage depends on whether the case settles or goes to trial.

What is the most common cause of birth injuries from negligence?

Common medical negligence causes for birth injuries include:

• Failure to monitor fetal distress
• Delayed or denied c-sections
• Improper use of delivery tools like forceps or vacuum extractors
• Medication errors
• Medical staff miss or ignore abnormal heart rate patterns

Does a difficult birth automatically mean medical malpractice occurred?

No, as birth complications can occur even when care is appropriate. Medical malpractice requires proof that the provider deviated from the accepted standard of care and that deviation directly caused a preventable injury.