The obstetrician, fetal asphyxia, and cerebral palsy

In the current legal climate, the recognition of cerebral palsy or other major brain dysfunction in a child is likely to lead to a malpractice action against the obstetrician who delivered the child. Perinatal asphyxia is usually considered the most likely cause of the brain damage, and the obstetrician is presumed by the lawyer either to have failed to recognize the fetal asphyxia or to have ignored it. In this essay, the illogic in this reasoning is discussed. While fetal asphyxia clearly can cause fetal brain damage, the infrequency of this relationship is stressed. The dilemma faced by the obstetrician as a result of modern perinatal care is discussed.