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Common Areas of Litigation Related to Care During Labor and Birth: Recommendations to Promote Patient Safety and Decrease Risk Exposure

Simpson, Kathleen Rice PhD, RNC, FAAN; Knox, G Eric MD

The Journal of Perinatal & Neonatal Nursing: April-June 2003 - Volume 17 - Issue 2 - p 110–125
Continuing Education

Reducing the risk of liability exposure and avoiding preventable injuries to mothers and infants during labor and birth can be relatively easy when all members of the perinatal care team (nurses, nurse-midwives, and physicians) agree to follow two basic tenets of clinical practice: use applicable evidence and/or published standards and guidelines as the foundation for care and whenever a clinical choice is presented, choose patient safety rather than production. Adhering to these two principles could theoretically eliminate the need for extensive and overly detailed policy and procedure manuals. Most clinicians feel the need to have some written guidelines for practice. A summary of the most common foci of professional perinatal liability claims together with the most current applicable evidence and published standards and guidelines from professional associations and regulatory agencies is provided. The purpose is to provide a framework for reviewing existing institutional protocols and/or developing future policies and guidelines that decrease professional liability exposure and minimize the risk of iatrogenic injury to mothers and infants.

From St. John's Mercy Medical Center, St. Louis, Mo (Simpson)

The Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minn. (Knox)

Corresponding author: Kathleen Rice Simpson, PhD, RNC, FAAN, St. John's Mercy Medical Center, 615 South New Ballas Rd, St. Louis, MO 63141 (e-mail:

Submitted for publication: November 7, 2002

Accepted for publication: January 18, 2003

© 2003 Lippincott Williams & Wilkins, Inc.