Every month I have the unenviable duty of reviewing federal medical malpractice cases to determine if the physician or midwife was at fault when a baby is born injured, dead or a pregnant woman dies. A panel of high-ranking federal officials listens to my presentation and then decides whether that doctor or midwife should be reported to the National Practitioner Data Bank, a place that essentially collects “data” on providers who have “messed up” or breached the standard of medical care.

After performing these reviews for several years there is a constant theme that keeps emerging: providers don’t listen to patients or nurses about important issues and inevitably harm is done. I suppose we are all a bit more sensitive about maternal death based on the popular TV series, Downton Abby, because of an episode where one of the beloved characters dies in childbirth. So, can anything be done to reduce the risks of pregnant women dying? Yes there is according to The Smart Mother’s Guide to a Better Pregnancy (TSMG) and here are some of its recommendations:

  • Select your provider very carefully and if he or she does not listen or is insensitive to your concerns and complaints, by all means change providers
  • Understand the importance of a fetal monitor strip and understand what and why “decelerations” can predict whether the baby is at risk for dying in labor. This topic is discussed on pages 201 and 202 of the book.
  • Meet the back-up obstetrician of your midwife or family practice doctor during the early part of your prenatal care and make sure he or she is contacted when you are admitted in labor. Why? Because a midwife or family practice physician can’t do a C. Section in the event of fetal distress or if your baby needs to be delivered immediately but an obstetrician can.
  • Trust your instincts. If you think something is “wrong” then it is until your provider or the hospital proves it’s not.
  • If you think something is going wrong while you’re in labor and your provider is not doing his or her job, ask to speak with the hospital administrator and request a second opinion from the chief of the obstetrics department or better yet, a maternal fetal medicine specialist.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.