The Medical Malpractice Crisis in Obstetrics: A Gestalt Approach to Reform
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MALPRACTICE CRISIS IN OBSTETRICS:
A GESTALT APPROACH TO REFORM
ELIZABETH SWIRE FALKER*
INTRODUCTION
Imagine you are pregnant, poor, and unmarried. You are liv-
ing in rural Georgia' and your baby is due soon. You have not had
a check-up since you found out you were pregnant, you have had
no access to prenatal care or education,' and you cannot find an
obstetrician to deliver your baby.' Some people would say this is
not surprising. This is a high-risk pregnancy with, at best, Medicaid
reimbursement.' Why would an obstetrician who already works
seven days a week put herself and her career on the line for you
when eighty to ninety percent of obstetricians can expect to be
sued during their career,' and malpractice rates have risen by up to
113 percent in a four-year period.6
Now imagine you are a young upper middle-class couple living
in a major city in the Northeast. You just found out you are preg-
* Litigation Associate, Battle Fowler LLP; J.D., Benjamin N. Cardozo School of Law,
1993; B.A., Wellesley College, 1988.
1 According to an article in the Washington Times, 17 counties in Georgia did not
have an obstetrician in 1986. See Risky Business DeliveringBabies, WASH. TiMFS, Oct. 20, 1989,
at F2; see also Sharman Stein, Gaining Options For Giving Birth - Legal Exemptions Could Allow
State's First Midwife Centers, CHi. TRIB., Apr. 19, 1995, at 1 (noting that fourteen contiguous
counties in southern Illinois were without an obstetrician).
2 See generally RogerJ. Bulger & Victoria P. Rostow, Medical Professional Liability and the
Delivery of Obstetrical Care, 6J. CoNTlMp. HEALTH L. & POL'Y 81, 83 (Spring 1990) [hereinaf-
ter Medical Professional Liability] (remarking that the problem of professional liability most
adversely impacts the delivery of obstetrical services to disadvantaged women, women living
in rural areas, and those with high risk pregnancies).
3 See id.
4 See id.; see also infra Part IA (discussing the problems that can arise during a high-
and low-risk delivery and the technologies used to combat these complications).
5 See Ruth Gastel, Medical Malpractice, INS. INFO. INsT. REP., Mar. 1997, at 12, available in
LEXIS, Insure Library, Allnews File (In a 1992 survey, the American College of Obstetri-
cians and Gynecologists found that... [e]ighty percent of [OB/GYNs] have been sued, an
increase of 71 percent over the prior five years.); see also Laurel Brubaker Caldkins, Who'll
Deliver the Babies, Hous. Bus. J., July 24, 1989, at 4, available in 1989 WL 2547489 (noting
that ninety percent of OB/GYNs can expect to be sued).
6 See Mary Jane Fisher, Obstetrical Liability Worries Doctors, NAT'L UNDERWarER, LIFE &
HEALTH/FN. SERVICES ED., Oct. 23, 1989, at 14, available in LEXIS, News Library, Nulife
File (reporting the findings of the Institute of Medicine that obstetricians are reluctant to
accept high-risk patients because of the 10% rise in all malpractice claims filed against
United States doctors between 1982 and 1986, and the fact that claims against obstetricians
are two to three times higher than other specialties resulting in increased malpractice in-
surance rates).](ViewImageLocal?handle=hein.journals/cardw4&div=6&collection=journals&method=preview&ext=.png&size=3)
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The Medical Malpractice Crisis in Obstetrics: A Gestalt Approach to Reform
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