The State of Iowa has agreed to settle an Iowa birth injury medical malpractice claim that will pay $2.15 million to the parents of the injured child and their attorneys along with $1,000 a month paid to the child’s guardians from April 2016 through November 2028, and then $2,570 per month through November 2068, which payments increase 3% annually, for a total payout of $1.6 million, as approved by the three-member Iowa State Appeal Board on March 7, 2016.
The parents’ Iowa birth injury medical malpractice claim alleged that the labor and delivery that took place at the University of Iowa Hospitals and Clinics were negligently managed resulting in a delayed Cesarean delivery, causing the newborn to suffer a catastrophic brain injury (hypoxic ischemic encephalopathy) with permanent disability.
The medical malpractice insurance for the hospital’s physicians will pay 70% of the settlement ($2.625 million) and the State of Iowa will pay $1.125 million.
According to the CDC, there were 3,988,076 births registered in the United States during 2014, up 1% from 2013. The number of vaginal deliveries in the United States in 2014 was 2,699,951; the number of Cesarean deliveries in the United States in 2014 was 1,284,551; and, the percent of all deliveries by Cesarean in the United States in 2014 was 32.2%.
For the period from 1990 through 2013, the low-risk Cesarean delivery rate reached a low in 1997 (18.4%) and then rose steadily to a high of 28.1% in 2009. The rate decreased from 2009 through 2013, reaching 26.9% (declines were widespread during this period). (Low-risk Cesarean delivery is defined as a Cesarean delivery among term (37 or more completed weeks), singleton, vertex (head first) births to women giving birth for the first time.)
The overall Cesarean delivery rate in the United States increased 60% from 1996 (20.7%) through 2009 (32.9%). Since 2009, the overall Cesarean delivery rate in the United States has declined slightly, to 32.7% in 2013.
Primary Cesarean deliveries (defined as a first Cesarean delivery regardless of the number of previous deliveries) account for approximately 60% of all Cesareans deliveries. Following the first Cesarean delivery, there is a very low probability (about 10%) of a subsequent vaginal delivery.
For 2013, rates of maternal morbidity were higher for Cesarean than vaginal deliveries—rates of transfusion (525.1 per 100,000) and ICU admission (383.1) were highest for primary Cesarean deliveries, while rates of ruptured uterus (88.9) and unplanned hysterectomy (143.1) were highest for repeat Cesarean deliveries. Higher rates of maternal morbidity for Cesarean compared with vaginal deliveries were found for nearly all maternal age groups and for women of all races and ethnicities. Women with no previous Cesarean delivery who had vaginal deliveries had lower rates for all maternal morbidities compared with those who had Cesarean deliveries. Women with a previous Cesarean delivery who labored and had vaginal birth generally had lower rates for most of the morbidities, but failed trials of labor were generally associated with higher morbidity than scheduled repeat Cesarean deliveries, especially for ruptured uterus, which was seven times higher (495.4 per 100,000 compared with 65.6).
Given the lower morbidity for vaginal compared with Cesarean deliveries, attempting a trial of labor is recommended for most women with no previous Cesarean as well as for low-risk women with a previous Cesarean delivery. However, although successful attempts at a trial of labor after Cesarean (i.e., leading to a vaginal birth after Cesarean [VBAC]) result in lower morbidity than planned repeat procedures, failed trials of labor result in increased morbidity.
If you or a loved one suffered serious harm as a result of a Cesarean delivery (or the failure to timely and properly perform a Cesarean delivery) in Iowa or elsewhere in the United States, you should promptly find a birth injury lawyer in Iowa or in your U.S. state who may investigate your birth injury claim for you and represent you and your child in a birth injury case, if appropriate.
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