Secrets to Safer Childbirth: Preventing Medical Errors in Pregnancy, Labor and Delivery

PART ONE: Key Tests and Choices

By Giles Manley, M.D.

It happens thousands of times a year in U.S. hospitals: a healthy pregnancy turns into a nightmare during labor and delivery with the birth of a brain-injured child. Although many birth injuries are the result of circumstances beyond anyone’s control, others are preventable.

As a board-certified obstetrician for more than 20 years, and now as an attorney who represents children with preventable brain injury, I have compiled what I call a “prevention checklist” for expectant parents.

This information is critical to your baby’s safety during pregnancy, labor and delivery. Armed with knowledge about potential problems and standards of care, you’ll be able to insist on appropriate actions from your doctor and hospital staff.

Have a Birthing Advocate with You

Choose a birthing advocate, either the unborn child’s father or another birthing partner, who is prepared to buttonhole physicians, medical staff and hospital personnel to demand answers and action.

Selecting a Physician and Hospital

Ask your prospective obstetrician how often he or she is in the hospital and who covers for them when they’re not available. Learn all you can about your backup physician as well as your primary doctor. Your local medical board can tell you if the doctor has lawsuits pending. If there are three or more, look further into the circumstances.

Choose a hospital with a 24-hour, in-house anesthesia team. If you choose a midwife, make sure your birth will be in a hospital and not a birthing center. This ensures you have immediate access to an operating room in case an emergency C-section is necessary.

The First 26 Weeks


The following information applies to healthy, normal pregnancy only. Women with complicated pregnancies require additional monitoring and testing that are not covered here.

Pre-Natal Tests


• Genetic counseling for women over the age of 34.
• If you weigh more than 200 pounds, get screened for diabetes in both the first and second trimesters.
• If you’re of Eastern European, Mediterranean or African-American descent, get screening for conditions related to these genetics
• At 16 weeks, you will be offered a “triple screen” for genetic abnormalities. Be aware that these are prone to false positives. Think about what you’d do if you learned of problems for your unborn child. If you would carry the baby to term no matter what, decline the “triple screen” and any additional testing. These diagnostic tests are invasive and put your baby at risk for miscarriage.
• An ultrasound should be conducted during your first doctor’s visit. This will accurately determine your due date. A repeat is done in the second trimester. However, insist it be performed only after 18-20 weeks when the fetal anatomy is clear enough to show abnormalities.

The above has been excerpted from Secrets to Safer Childbirth: Preventing Medical Errors in Pregnancy, Labor and Delivery. Be sure to check future issues for parts two through four of this four-part series.

Giles Manley, M.D. is Medical Director of the CP Family Network. If you have questions about whether standards of care were followed during your pregnancy and delivery, you may contact him at info@cpfamilynetwork.org.