Our law firm, Cap & Kudler, represents a woman who was recommended to a midwife service owned by a group of midwives to assist her in the birth of her first child. After speaking with the company, the client chose to use their service for an in-home birth. As she was giving birth, there was a complication that resulted in what is called a fourth-degree tear (a severe tear of the skin between the vagina and the rectum). Rather than make sure the client was taken to the hospital for such a serious condition, the midwife offered to do and performed the repair herself—a procedure which even many qualified obstetricians are unqualified to do.
Below are the basic facts of the complaint we have filed on our client’s behalf:
The plaintiff (our client) sought prenatal care and home delivery services with the defendant on or about April 06, 2017, and decided to hire the defendant for those purposes.
The plaintiff went into labor on August 26, 2017, at approximately 04:45. The defendant and one of her students arrived at our client’s home at approximately 16:00 on August 26, 2017. At the time of the defendant’s arrival, the plaintiff was almost completely dilated (first stage of labor). The next stage (second stage) of labor is pushing the baby through the birth canal and delivery of the baby. When the plaintiff delivered her baby, she suffered a fourth-degree tear (laceration) of her vagina. This usually occurs when the baby’s head delivers uncontrollably.
A fourth-degree tear of the vagina is one of the most serious complications that can occur during vaginal delivery and is considered to be an emergency that must be repaired immediately by a competent, experienced, well-trained obstetrician, gynecological oncologist, pelvic surgeon, and/or rectal surgeon. A fourth-degree vaginal tear is a laceration through the vaginal wall and into the rectum allowing fecal material and gas to pass out of the vagina. This type of laceration also includes a complete tear of the rectal sphincter (muscle surrounding the anus) which controls one’s ability to voluntarily hold stool in the rectum. Our client’s tear was very large.
It takes years of special training, skill, and experience to properly repair these serious lacerations through surgery. Only well-trained, highly skilled obstetricians, gynecological oncologists, pelvic surgeons, and/or rectal surgeons who have proper credentials and prior experience should even attempt to repair a laceration of this type.
Rather than making sure her patient got the proper care from a qualified doctor, the midwife advised her that this was something she could handle and convinced the client to allow her to do so. Predictably, the repair was not properly done and the client had long term complications including passing gas and feces from her vagina until the repair was eventually properly made. During this time, the client relied on her midwife’s continued assurances that everything was proceeding as expected further delaying her seeking proper treatment.
In this case, the Defendants have advised us that they are not required by law, and do not have, any insurance to cover the damages they have caused in this case. Nevada Law needs to be changed. We believe the industry offers a vital service to those who choose to use it, but this industry is in dire need of better regulation, including the requirement that they maintain insurance for situations such as this, where the Defendants caused severe damage to the client, including the need for a second surgery.
The client understands that she is not likely to recover any compensation for the injuries she received as a result of the surgery performed on her by the Defendant. However, she feels that there is a need for others to be informed of the lack of regulation, licensing, and insurance requirements in the hopes that this will change in the future, preventing others from ending up in a similar situation. We, also, understand that we are not likely to be compensated for any recovery in this case. Our goal is to protect people who may choose to use midwife services in the future by seeking State regulation of the practice, including the need to provide insurance from which the patient can be compensated in case of an injury such as this.