Understanding the Impacts of Nursing Negligence During Birth 

Nurses play an important role in monitoring labor, recognizing changes, communicating concerns and helping the delivery team respond when a mother or baby may need urgent care. This page can help families understand how nursing mistakes may contribute to birth injuries and what options may be available after a difficult delivery.

What is nursing negligence during labor and delivery?

Nursing negligence during birth refers to care that may fall below accepted nursing standards during pregnancy, labor, delivery or the immediate newborn period. In labor and delivery, nurses are often the team members who spend the most time monitoring the mother and baby, documenting changes and communicating with physicians, midwives and other providers.

A nursing mistake does not always mean a child was harmed or that malpractice occurred. However, when a nurse fails to recognize a concerning change, communicate it to the right provider or follow appropriate protocols, a baby may lose valuable time during a medical emergency.

Signs and symptoms families may notice

Nursing negligence is not a diagnosis itself. The signs families may notice usually depend on the injury their baby experienced. After a difficult labor or delivery, parents may be told their child needs evaluation or treatment for concerns such as:

• Abnormal fetal heart rate patterns or non-reassuring fetal status during labor
• Low oxygen concerns before, during or shortly after birth
• Need for resuscitation, breathing support or NICU care after delivery
• Seizures, abnormal movements or unusual levels of alertness
• Poor feeding, weak cry, abnormal muscle tone or unusual stiffness or limpness
• A diagnosis such as hypoxic-ischemic encephalopathy, cerebral palsy or another neurologic injury
• Weakness, limited movement or loss of function in an arm or shoulder
• Developmental delays that become clearer as the child grows

If your baby is showing concerning symptoms, medical evaluation should come first. A legal review can happen later, once your child is safe and the medical records can be carefully examined.

What can contribute to birth injuries involving nursing care?

Birth injuries can have many causes, and some happen even when everyone on the medical team acts appropriately. In cases involving nursing care, concerns often relate to missed warning signs, delayed communication or failure to follow a hospital protocol during a rapidly changing situation.

• Failure to monitor or document fetal heart rate patterns and maternal vital signs appropriately
• Delayed recognition of non-reassuring fetal heart rate patterns or signs that the baby may not be tolerating labor well
• Failure to promptly notify a physician, midwife or supervisor when the mother or baby shows signs of distress
• Problems with Pitocin or oxytocin administration, including failure to monitor contractions and fetal response
• Failure to follow protocols for maternal bleeding, blood pressure changes, infection concerns or emergency escalation
• Incomplete handoffs, poor documentation or communication breakdowns between members of the care team
• Improper placement or use of fetal monitoring equipment when accurate monitoring is needed

When nursing negligence may be medical malpractice

Not every birth injury is caused by malpractice, and not every poor outcome means a nurse did something wrong. Medical malpractice may be involved when the records show that a nurse or hospital team failed to meet the standard of care and that failure contributed to a preventable injury.

Scenarios that may point to negligence include:

• Concerning fetal monitoring patterns were present but not recognized or escalated in a timely way
• The nursing team did not communicate important changes to the doctor, midwife or supervising provider
• A mother or baby showed signs of distress but appropriate emergency steps were delayed
• Pitocin or another labor medication was continued despite concerning contraction patterns or fetal heart rate changes
• Hospital protocols for monitoring, documentation, escalation or emergency response were not followed
• Nursing handoffs failed to include important clinical information, leading to delayed care
• The baby required urgent treatment after birth that may have been connected to missed warning signs during labor

Wais, Vogelstein, Forman, Koch & Norman, LLC works with medical experts to review fetal monitoring strips, nursing notes, physician communication, medication records and delivery timelines to determine whether nursing negligence may have played a role in a child’s injury.

Treatment and long-term outlook

Treatment depends on the type and severity of the injury. Some babies need short-term monitoring, while others may require urgent newborn care, specialist follow-up or long-term therapy and support.

Care after a birth injury may include:

• NICU monitoring and breathing support when a baby has trouble after delivery
• Therapeutic hypothermia for some newborns with moderate or severe oxygen-related brain injury, when medically appropriate and started within the recommended window
• EEG monitoring, seizure treatment or consultation with pediatric neurology
• Imaging studies, developmental evaluations and ongoing pediatric follow-up
• Physical therapy, occupational therapy, speech therapy or early intervention services
• Specialist care for nerve injuries, weakness, orthopedic concerns or feeding challenges

Some children recover well after a difficult start, while others need lifelong care. Understanding what happened during labor and delivery can help parents make informed decisions about medical care, early support services and whether a legal review may be appropriate.