It has never been safer to have a baby and never more dangerous to be
an obstetrician. In a recent survey, 76% of obstetricians in the United States
reported having faced litigation at some point in their careers—most
often for having allegedly caused cerebral palsy (CP).1 Similar
trends have been seen in Australia, where the 2% of physicians who are obstetricians
are now associated with 18% of the cost of all medical indemnity claims.2,3 The median award for “medical
negligence in childbirth cases” is $2.3 million.4 Consequently,
obstetricians pay some of the highest premiums for malpractice insurance—up
to $200 000 per year in some states. These figures might seem to indicate
an epidemic of errors in the delivery room, except that the common assumption
that obstetric caregivers can prevent CP by actions taken during labor and
delivery is based largely on erroneous assumptions and obsolete science. Despite
this, in the United States, 60% of malpractice insurance premiums paid by
obstetricians cover lawsuits for alleged birth-related CP.5 Less
than 10% of plaintiffs in CP cases receive any compensation, and more than
60% of obstetric premiums are spent on the legal process.5
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