Obstetric litigation: Effects on clinical practice

Many claims concerning extent and consequences of litigation have been made , despite a tack of comprehensive and widely available data. It has been su ggested that a rapidly increasing rate of litigation has caused problems in the recruitment and retention of obstetricians, and has also caused practi tioners to practice 'defensively'. This article discusses meaning and signi ficance of defensiveness within obstetrics and midwifery and quantifies the incidence of certain examples of defensive practice. Based on large-scale postal surveys of obstetricians and midwives in Scotland and England, as we ll as follow-up interviews, it clarifies the significance of what has becom e known as defensive medicine in maternity care, notably in relation to cae sarean sections. It then examines the role of clinical risk management, and the growth of protocols and guidelines in particular, in trying to limit l itigation. Copyright (C) 2001 S. Karger AG, Basel.