Anesthesiologists must make very specific calculations when administering any drugs to women, particularly when performing an epidural. They must ensure that they use the correct medication, carefully calculate and measure the amount, and administer it properly (especially for epidurals). Even a minor deviation from the correct procedure can cause life-altering injuries to the mother or child.
Background: Anesthesia Options
Some women choose a natural childbirth without medication. Women can choose this option whether they opt for childbirth in a hospital setting, or with a midwife at a birth center.
Drugs and Analgesics
Sedatives or narcotics can be used early in the labor to minimize pain and relax the expectant mother. Drugs used often include fentanyl, morphine sulfate, and demerol. Complications can include respiratory depression and increased risk of aspiration with the baby. These drugs should not be given close in time to the expected delivery.
Anesthetic, usually similar to lidocaine, is injected into the pudendal nerve. This procedure is often used when delivery occurs by forceps or vacuum; it is also used just before an episiotomy. It is usually given during the second stage of labor, just before delivery. There is some risk that the anesthetic can cross the placenta and travel to the baby.
Local anesthesia is used for patients, who did not use anesthesia for the delivery, who require an episiotomy (repair of vaginal tears from childbirth)
Epidurals are used to limit the amount of pain associated with childbirth. It is usually administered during the active phase of labor, and is inserted into the space between L3 and L4 in the spine (in the lower back). The amount of medication can be increased if a cesarean delivery is required.
Anesthesiologists are taught to perform epidurals by a process known as “The Four P’s.” These are Preparation (the doctor must use the correct needle and type/dose of medicine), Position (the patient must be properly positioned—for a woman in labor, usually on her side), Projection (the needle must be properly placed at the expected insertion point) and Puncture (the needle must penetrate the spinal column without entering the spinal sac). If not properly performed, the mother can suffer from the following epidural injuries:
- Nerve damage
- Cardiac arrest
- Difficulty breathing
Additionally, errors can cause injuries to the baby, as well:
- Brain injury
General Anesthesia and Spinal Anesthesia
General and spinal anesthesia are often used for cesarean deliveries. One complication linked to spinal anesthesia is low maternal blood pressure, which can cause low heart rate in the baby. General anesthesia is more frequently used for emergency cesarean deliveries. The risks include placental abruption, low heart rate for the baby, umbilical cord prolapse, uterine rupture and placenta previa.
If you believe that your anesthesiologist acted improperly during your labor and delivery and caused injury to you or your child, contact our medical malpractice lawyers at (855) 712-7818 or fill out our online form for a free consultation.
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