The American College of Obstetricians and Gynecologists has recently released findings from its 2009 Survey on Professional Liability, which asked practicing ob/gyns and ob/gyn residents if and how their practices have been affected by liability concerns. Respondents were asked whether they had made any practice changes since January 2006 because of the affordability or availability of professional liability insurance, or because of fear of liability claims or litigation.
Among the findings, 59.2% (of 5,644 respondents) reported having made one or more changes to their practice since 2006 for reasons related to the availability and affordability professional liability insurance. Of those reporting making changes for this reason, 19.5% reported increasing the number of cesarean deliveries and 19.5% indicated they stopped performing or offering VBACs.
In addition to making changes based on the availability and affordability of insurance, many ob/gyns report having made changes to their practices because of fear of professional liability or litigation (in other words, out of fear of being sued or being held responsible for a negative outcome). 62.9% (of the 5,644) reported having made one or more changes to their practice for this reason. Of those, 29.1% reported increasing the number of cesarean deliveries, and 25.9% stopped offering and performing VBACs. 20-30% (depending on whether the question was about availability of liability insurance or fear of liability claims) also reported decreasing the number of high-risk obstetric patients they cared for.
These findings probably don’t surprise many birth advocates, who have expressed concern that ob/gyns are limiting women’s birth options for reasons other than medical evidence and an individual woman’s preferences.
For more discussion of this topic, see Why is Maternity Care Like This?, an excerpt from “Our Bodies, Ourselves: Pregnancy and Birth.”