The NHS does not have infinite resources, and the resources it does have must be distributed over a great many care centres and a great many patients. The decisions that are made regarding allocation of funds are inevitably controversial issues, as are any measurands that attempt to quantify life quality and duration as a function of cost. As a result services are stretched in many areas and these include obstetric units. The vision of a busy obstetric unit with nurses and midwives hurrying to attend to numerous mothers in labour, a shortage of consultants, busy theatres and premature baby units may easily suggest a degree of chaos and a consequent lack of adequate care with the possibility of medical negligence.
Birth is a traumatic experience. During the process inevitably there will be periods when the baby experiences less than optimal oxygen levels and cerebral blood flows. Proper obstetric care includes managing these factors and maintaining adequate levels. If they fall too low the baby will likely die or develop cerebral palsy. The primary question is how often a failure in obstetric care will result in the development of cerebral palsy or will exacerbate a condition of cerebral palsy that has already developed in the womb.
Extensive statistical studies have been carried out which conclude that the maximum number of cerebral palsy cases that can be attributed to less than adequate care during birth is less than two percent of all cases. Statistically this is a small number, but in human terms it means that in the UK thirty babies a year are condemned to suffer from this disabilitating condition exclusively due to medical negligence.
As discussed, resource allocation decisions play a part in this. The hidden cost of caring for these thirty human beings for the rest of their lives should be accounted for in the resourcing decisions.
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The most common birth defect is cerebral palsy which affects one in five hundred babies. Cerebral palsy comes in numerous guises but they all relate to brain damage occurring before, during or shortly after birth. The vast majority occur in the womb, but there is a concern that many avoidable cases occur due to medical negligence during birth. We will look at both sides of this argument.
