Risk Management in Obstetrics
Obstetrics is defined as the branch of medicine which deals with the care of women during pregnancy, childbirth, and the period during which they recover from childbirth (Agency for healthcare research and quality, 2000).
The major factor that makes obstetrics a high risk area is expectation. The majority of women who are about to give birth tend to be young and healthy (Clements, 2001). Naturally, they expect to give birth to a healthy child, who is free from defects and/or illness. A key reason for such high expectations may also stem from the belief that society has become so technologically advanced that complications during birth are now a thing of the past. Hence, if the baby is born with a birth/neurological defect, the parents feel that someone in a position of authority is to be blamed (Herczeg, 1997).
Litigation in obstetrics has been noticeably increasing, with tremendous impact on obstetric medical practice. For instance, in the state of Washington, approximately 45% of family physicians who practice obstetrics have considered stopping obstetric practice, over concerns of increasing malpractice insurance rates (Norris, 2003). In England, 27% of litigation claims were related to Obstetrics and Gynaecology, totalling approximately £6,876,033 (Wilson, 1999). In Canada, 1 in 7 obstetricians/gynaecologists can expect to be sued in a given year (Sibbald, 1999). Other effects of increased litigation also mean a large part of funding allocated towards healthcare may end up being diverted towards litigation cases (Herczeg, 1997).
Problems with risk identification
All pregnant patients can be at risk for complications. In fact, Clements (2001) notes that a pregnancy can only be called "healthy" in retrospect. Hence, pregnant women can only be classified as being at low or high risk; the former being those who do not have any major health problems while in pregnancy, whereas the latter... [continues]
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