The doctors who were most sued for malpractice in 1984 were those who deliver babies, the American Medical Association says.
Most suits against obstetricians are over the birth of a physically or mentally impaired baby.
Nature is mainly responsible for the fact that from one to three babies in 100 are born with some physical or mental defect or both. But some such births can be caused by misuse of forceps (often a life-saving instrument), failure to do a cesarean section soon enough, failure to monitor the baby assiduously in the hours before delivery and other missteps of doctors or other hospital personnel.
The St. Paul Companies of St. Paul, Minn., are the nation's largest malpractice insurors, covering nearly one U.S. doctor in five.
Here is what these experienced companies tell obstetricians who want to minimize their chances of being sued (this from the winter issue of Perspective, a publication of Ohio Blue Cross-Blue Shield). The tips will be interesting to prospective parents -- and may even prompt a few timely questions.
"1. Never consider a pregnancy to be routine.
"2. Anticipate problems.
"3. Don't hesitate to consult [another physician] when in doubt.
"4. Communicate with patient and family.
"5. Communicate with other health professionals nurses, technicians, etc. .
"6. Don't ever give the impression of abandoning the patient.
"7. Recognize the obstetrics unit's limitations.
"8. Know the facility's emergency measures.
"9. Document everything.
"10. Keep up to date."
To me, these suggest a few questions that parents-to-be might sometimes ask their obstetricians:
*Do you foresee any problems at all?
*What can we do to help prevent any problems and insure a good birth and healthy baby?
If trouble impends before birth:
*Is a careful watch being kept on me (or my wife)?
*Is this hospital, or its emergency unit, prepared to deal with this kind of problem? If not, who is?
*Should we be getting some other specialized opinions or help with this problem?
My younger daughter's first baby was born with a severe, life-threatening problem. The baby was delivered at a good community hospital. But when the obstetrician felt help was needed, he wasted no time rushing the baby to a nearby university medical center, where treatment was prompt and, happy to say, effective.