Fetal Monitoring and Cerebral Palsy

An accomplished neurologist and attorney, Dr. James C. Johnston has published extensively on medical malpractice litigation. Dr. James C. Johnston co-authored a paper discussing cerebral palsy litigation and electronic fetal monitoring. It was published in the 2014 Journal of Child Neurology.

Electronic fetal monitoring, used for over four decades after its introduction without any clinical trials, has repeatedly proven clinically ineffectual, with a 99% false positive prediction of fetal distress, thereby increasing C-section rates with resultant harm to mothers and newborns alike. It has not affected the incidence of cerebral palsy, perhaps unsurprising when one considers the vast majority of cases develop before labor.

Nevertheless, electronic fetal monitoring today remains the most common obstretrical procedure, even as evidence against its efficacy countinues to mount. It is the foundation for the continuing cerebral palsy birth injury litigation crisis, increasing malpractice costs and even driving skilled physicians away from the delivery room. Fetal monitoring also compels obstetricians to commit daily ethical breaches, ignoring the principles of informed consent and non-maleficence or ‘do no harm.’

Thomas P. Sartwelle and Dr. James C. Johnston propose a straightforward solution that would change the standard of care, link electronic fetal monitoring to the exclusionary doctrine recognized by all the world’s courts – Daubert – and end cerebral palsy litigation.


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