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Caesarean or Natural Birth? Your Preferences Must Be Respected!

Hospital SignMedical professionals are obliged by law to respect their patients’ preferences and to fully inform them of all the treatment options. In one case that proved the point, a mother who gave birth to a disabled twin after a midwife advised her against a Caesarean delivery triumphed in a compensation claim against the NHS.

The mother’s nephew, also a twin, had previously died during his conventional birth. As a result of that tragedy, she had expressed the wish throughout her pregnancy that her children should be born by Caesarean. A consultant who interviewed her early on in her pregnancy had made a note on her file that she should be delivered by Caesarean if she so wished.

However, a midwife who saw her later in her pregnancy overlooked that note and advised her that she should give birth naturally. She complied with that advice and one of her twins, a boy, suffered a brain haemorrhage during his forceps delivery. He faced a lifetime of disability and, with a view to securing the funds needed to pay for his care, his mother sued the relevant NHS trust on his behalf.

The trust accepted that, but for the midwife’s advice, the boy would have been born by Caesarean unharmed. In upholding the mother’s claim, a judge accepted that she had felt under pressure to comply and unable to put her foot down and insist on a Caesarean delivery.

In challenging the judge’s ruling before the Court of Appeal, the trust’s lawyers argued that the consultant’s note was very small and easy to miss. The midwife had faithfully followed protocols and the advice that she gave to the mother was clinically correct. In refusing permission to appeal, however, the Court could detect no flaw in the judge’s assessment of the evidence. The amount of the boy’s compensation had yet to be assessed, but was likely to be a seven-figure sum.

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