Obstetrics has the most critical medical malpractice problems. Routine prenatal
care and delivery are the cornerstones of community health. These are imperiled
by fears, both real and imagined, of litigation. Physicians in rural areas find
it increasingly difficult to obtain affordable malpractice insurance coverage.
Urban physicians turn away indigent patients in a mistaken belief that they
pose an elevated risk of malpractice litigation. Under federal antidumping
regulations, physicians will face these same patients as emergency admissions
late in labor, when they may present a greater legal risk.
It is not possible to prevent every birth-related lawsuit. It is possible to
limit systems failures and attendant negligent injuries, to correct patient and
attorney misapprehensions about birth injuries, and to document better the
nonnegligent basis of most birth injuries. Our belief, based on our experience
with medical malpractice litigation and insurance claims management, is that
such strategies will greatly reduce the incidence of birth-related lawsuits
while providing excellent, cost-effective medical care.
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