Obstetrics involves two patients simultaneously. When the medical team fails either the mother or the baby during pregnancy, labor, delivery, or the postpartum period, the consequences can be irreversible and the financial burden can last a lifetime. Obstetrics and gynecology generates approximately 24 to 25 percent of all medical malpractice claims filed in the United States — more than any other specialty after general surgery. More than 60 percent of OB-GYNs have been sued at least once during their careers, according to the American Medical Association.
The damages in serious birth injury cases reflect the stakes. In 2024, a Michigan jury awarded $120 million to the family of a child who suffered severe cerebral palsy after an obstetrician delayed a medically necessary C-section for several hours despite documented signs of fetal distress. A 2023 Pennsylvania case resulted in a $182.7 million verdict in a similar birth injury matter. Average lifetime care costs for a child with cerebral palsy reach approximately $1.6 million — and in severe cases, expert-projected lifetime care needs can far exceed that figure.
What Makes Obstetric Cases Distinctive
In most malpractice cases, the injured patient is the same person whose care was at issue. In obstetric cases, the child born with a birth injury has their own separate claim entirely distinct from any claim the mother may have. In Texas, the child’s statute of limitations does not expire until their 14th birthday, but evidence — fetal monitoring strips, delivery room notes, nursing documentation — becomes harder to interpret and harder to obtain as years pass.
The economic damages available in serious birth injury cases are also distinctive in their magnitude. A child with hypoxic-ischemic encephalopathy or severe cerebral palsy may require around-the-clock attendant care, adaptive equipment and home modifications, specialized therapies, and continued medical management for their entire life. Life care planners project these costs across the child’s expected lifespan. Because economic damages are not capped in Texas, these projections form the most significant part of recovery in catastrophic birth injury cases.
The Most Common Obstetric Malpractice Claims
Failure to Recognize and Respond to Fetal Distress
Continuous electronic fetal monitoring during labor produces a record of fetal heart rate patterns. Certain patterns — late decelerations, variable decelerations that do not recover, prolonged bradycardia — indicate that the fetus may not be tolerating labor and may be developing oxygen deprivation. Recognizing these patterns and responding with appropriate interventions (repositioning, supplemental oxygen, cessation of Pitocin, or emergency delivery) is a core standard of care in labor and delivery. Research from Coverys, a national malpractice insurer, found that cerebral palsy or brain injury was involved in 41 percent of birth injury malpractice claims, and that failure to monitor fetal heart rate and respond to distress signals was among the most common contributing factors.
Delayed Cesarean Section
When vaginal delivery presents unacceptable risk to the mother or baby, prompt cesarean delivery is indicated. Delay in performing a necessary C-section is one of the most frequently litigated obstetric malpractice scenarios. The $120 million Michigan verdict in 2024 involved an obstetrician who identified the urgent need for a C-section but did not perform it for several hours, during which the baby suffered oxygen deprivation that caused severe cerebral palsy. The standard is not perfection but reasonable, timely action once the indication is recognized — and when documentation shows the indication was identified and ignored, liability can be difficult to contest.
Improper Use of Forceps and Vacuum Extractors
Operative vaginal delivery instruments are appropriate in specific clinical circumstances when the baby has descended far enough and delivery needs assistance. Used outside their appropriate indications, applied with excessive force, or attempted too many times, they can cause skull fractures, intracranial hemorrhage, facial nerve palsies, and brachial plexus injuries. Approximately 12,000 babies develop Erb’s palsy annually from birth injuries, many involving improper use of delivery instruments or mishandled shoulder dystocia.
Shoulder Dystocia Mismanagement
Shoulder dystocia occurs when a baby’s head delivers but the shoulders become impacted against the mother’s pubic bone. It is a true emergency requiring immediate, systematic performance of specific obstetric maneuvers. A team that is unprepared, that applies excessive lateral traction rather than the correct protocol, or that fails to escalate appropriately can cause permanent Erb’s palsy or more severe brachial plexus injury. The management of shoulder dystocia is one of the most thoroughly documented standards of obstetric care, and deviation from it is clearly actionable when harm results.
Failure to Diagnose Preeclampsia
Preeclampsia is a hypertensive disorder of pregnancy that is a leading cause of maternal mortality in the United States. Its hallmarks are elevated blood pressure and evidence of end-organ damage. Monitoring blood pressure at every prenatal visit and responding promptly to elevated readings are basic standards of care. Failing to diagnose preeclampsia in a patient with documented hypertension and proteinuria, or failing to deliver when severe features are present, can be catastrophic for both mother and baby.
Postpartum Hemorrhage
Postpartum hemorrhage is the leading cause of maternal death globally. Hospitals are required to implement evidence-based hemorrhage protocols including uterotonic medications after delivery, fundal massage, and escalation to blood transfusion and surgical intervention when conservative measures fail. Failure to quantify blood loss, failure to recognize hemorrhage in progress, and failure to respond aggressively and promptly when hemorrhage is identified are documented failures that have cost mothers their lives and their uteruses.
Failure to Diagnose Ectopic Pregnancy
An ectopic pregnancy is a medical emergency that is treatable before rupture and potentially fatal after. Any patient with a positive pregnancy test and pelvic pain or vaginal bleeding should be evaluated with serial hCG levels and transvaginal ultrasound. Sending such a patient home without that evaluation, or failing to follow up on an abnormal hCG pattern, can result in rupture, internal hemorrhage, and death.
Common Gynecologic Malpractice Claims
- Failure to follow up on abnormal Pap smears, leading to delayed cervical cancer diagnosis
- Missed diagnosis of ovarian, uterine, or other gynecologic malignancy despite symptoms or imaging findings that warranted workup
- Unrecognized bowel, bladder, or ureteral injury during laparoscopic or robotic surgery
- Complications of hysterectomy involving damage to surrounding structures
- Failure to diagnose endometriosis despite a classic, longstanding symptom presentation
Filing Deadlines in Texas
In Texas, the mother’s two-year statute of limitations runs from the date of the injury. For the child’s claim, it does not expire until the child’s 14th birthday under Section 74.251 of the Texas Civil Practice and Remedies Code. Despite this extended window, early investigation matters: electronic fetal monitoring strips may only be retained for a limited period, and witness memories fade. The sooner investigation begins, the stronger the case can be built.
How Anunobi Law Evaluates Birth Injury and OB-GYN Cases
What sets Anunobi Law apart in obstetric and gynecologic malpractice cases is something most firms cannot offer: a board-certified OB-GYN physician on our team. This physician serves as the clinical conscience of the firm, reviewing potential cases for medical merit before a single legal step is taken. In a specialty where fetal monitoring strips, delivery decisions, and obstetric emergencies must be understood at a clinical level, having that expertise in-house means we can identify the failures that matter, ask the right questions of experts, and build cases grounded in real medical understanding.
Anunobi Law is headquartered in Houston, Texas, and represents patients and families in birth injury and OB-GYN malpractice cases nationwide. If your child was born with a brain injury, cerebral palsy, or another birth-related condition, or if you experienced a serious complication during or after delivery, we encourage you to reach out for a free, confidential case review.
Call or contact Anunobi Law today. There is no cost and no obligation, and your family deserves to know whether what happened was preventable.