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Miscarriage, childbirth and psychological injury

View profile for Robert Dempsey
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A report in the news today (15 January 2020) highlights findings that miscarriage may lead to long-term post traumatic stress.  The study of 650 women carried out by Imperial College in London found 29% of women who had had a miscarriage showed the symptoms.

The study is relevant when considering the role of clinical negligence relating to childbirth.

It is accepted that if a child is injured during pregnancy or childbirth as a result of negligence, the mother can claim as a “primary victim”, i.e. the connection with the child is so close, the mother is also a victim of the same negligence. 

It is still, of course, necessary to show the mother has been injured in some way.  Often there are physical as well as psychological symptoms.

Issues may arise, however, where there are no physical injuries and it is this that makes today's findings noteworthy.

The report refers in general terms to “stress”, “anxiety” and “depression”.  Clearly these are all symptoms that should not be underestimated but can fall short of a recognised psychological condition.

Clinical psychologists have established systems to classify psychological injury.  These systems look at various criteria such as mood disturbance, medical related anxiety or sleep disturbance.  It is possible for the mother to have a number of these symptoms but without fully meeting the criteria for a psychological “condition” such as Post Traumatic Stress Disorder.  If a mother does not have a physical injury, but has symptoms that do not fall into the category of a psychological injury, she will not be entitled to compensation.

This could mean that a mother who has experienced a difficult childbirth caused by negligence may be left with psychological difficulty and anxiety but, in the absence of a physical injury, may be left without a remedy.

Returning to today’s report, it is of, course, not suggested miscarriage or indeed any difficulties associated with childbirth are necessarily as a result of negligence but it does show the far-reaching impact of anxiety and distress may not always lead to a remedy in law, even where negligence has taken place.