The Ohio standard of care during labor and delivery requires physicians, nurses, and hospitals to provide the same level of skill, care, and diligence that a reasonably prudent obstetric provider would use under similar circumstances. This standard comes from the Ohio Supreme Court's decision in Bruni v. Tatsumi, and it applies to every stage of childbirth, from fetal heart rate monitoring to the decision to perform an emergency cesarean section.
Beausay Law Firm has spent more than 40 combined years representing Ohio families in medical malpractice and catastrophic injury cases, and our attorneys have recovered millions of dollars for babies harmed when caregivers failed to meet this standard, including settlements in birth injury cases involving mismanaged fetal monitoring and oxygen deprivation.
Partner Jacob J. Beausay has published legal research on Ohio's affidavit of merit rule, a procedural requirement unique to malpractice claims, and Senior Counsel T. Jeffrey Beausay brings nearly 40 years of trial experience, including 15 years spent representing hospitals and insurers before shifting his focus to plaintiffs in 2001. That combination gives our team a detailed, firsthand understanding of how hospitals and their insurers evaluate labor and delivery claims from the inside.
Understanding what the standard of care actually requires is the first step toward recognizing whether your child's injury may have resulted from negligence rather than an unavoidable complication.
How Ohio Law Defines the Medical Standard of Care
Ohio courts define medical negligence through the framework set out in Bruni v. Tatsumi, 46 Ohio St. 2d 127 (1976). The Ohio Supreme Court held that a plaintiff must show a provider did something (or failed to do something) that a physician of ordinary skill, care, and diligence would not have done under like circumstances, and that this conduct directly caused the injury.
To succeed in a labor and delivery malpractice claim, Ohio law requires proof of three elements, as summarized by the Fourth District Court of Appeals in Wallace v. Southern Ohio Medical Center, 2011-Ohio-3570:
- The applicable standard of care for the specific medical specialty involved
- A breach of that standard of care by the physician, nurse, or hospital
- Proximate cause connecting the breach to the injury the baby or mother suffered
Because these elements are highly fact-specific, Ohio law generally requires expert medical testimony to establish the standard of care in a given delivery.
What Does the Standard of Care Look Like During Labor and Delivery?
During labor, the standard of care generally requires providers to monitor the fetal heart rate closely enough to catch signs of distress before they become dangerous. The American College of Obstetricians and Gynecologists (ACOG) has published clinical guidance establishing how fetal heart rate tracings should be interpreted and how often they should be reviewed.
Under ACOG's three-tier classification system, fetal heart rate tracings fall into one of three categories:
- Category I (normal): A reassuring tracing that requires no specific intervention.
- Category II (indeterminate): A tracing that requires continued monitoring and evaluation, since it is neither clearly normal nor clearly abnormal.
- Category III (abnormal): A tracing requiring prompt intervention, up to and including delivery, if the pattern does not resolve.
For patients without complications, ACOG recommends the fetal heart rate be reviewed roughly every 30 minutes during the first stage of labor and every 15 minutes during the second stage.
Wallace v. Southern Ohio Medical Center illustrates how Ohio courts apply these clinical standards. That case involved a fetal monitoring strip showing heart rate decelerations, followed by a cord prolapse. The court examined expert testimony about how the medical team interpreted and responded to the strip. When a provider fails to recognize or act on a non-reassuring tracing, that failure can form the basis for a standard-of-care violation.
Common Types of Labor and Delivery Negligence
Substandard care during childbirth can take several forms. The most common types of birth injury cases our attorneys see in Ohio include:
- Failing to recognize or respond to a non-reassuring fetal heart rate tracing
- Delaying a necessary emergency cesarean section
- Mismanaging shoulder dystocia, leading to brachial plexus or nerve injuries
- Medication errors involving labor-inducing drugs such as oxytocin
- Failing to identify or treat maternal hemorrhage or infection promptly
- Improper use of forceps or vacuum extraction devices
Any one of these failures can cause lasting harm to a newborn or mother, particularly when oxygen deprivation occurs during a critical window of delivery.
How a Bad Outcome Differs From a Standard of Care Violation
Not every difficult birth or injured baby is the result of malpractice. Childbirth carries inherent risks, and some complications occur even when every provider acts appropriately. Ohio law requires more than an unfortunate result. A family must show that a provider's specific conduct fell below what a reasonably careful obstetric team would have done, and that this specific failure caused the injury.
This distinction matters because it shapes how a case is investigated. Our attorneys review several key pieces of evidence before determining whether a birth injury meets Ohio's legal threshold for malpractice:
- The complete fetal monitoring strips from labor and delivery
- Nursing notes documenting observations and response times
- Physician orders and the timing of any interventions
- Independent expert opinion on whether the standard of care was met
How Common Are Labor and Delivery Injuries?
Birth-related brain injuries remain a significant public health concern in the United States. According to the Centers for Disease Control and Prevention, cerebral palsy is the most common motor disability of childhood, and several factors shape how often it occurs:
- Roughly 1 in 345 children in the U.S. has been identified with cerebral palsy
- Prevalence is notably higher among children born preterm or at low birthweight
- Oxygen deprivation during labor and delivery is a recognized contributing factor in a portion of cases
While not every case of cerebral palsy stems from medical negligence, these risk factors are why prompt medical and legal evaluation matters when a family suspects something went wrong during birth.
What to Do If You Suspect a Standard of Care Violation
If you believe your child's injury resulted from substandard care during labor and delivery, timing and documentation both matter.
Ohio Revised Code 2305.113 generally gives medical malpractice claimants one year from the date of the alleged malpractice to file suit, with a four-year statute of repose that can bar claims regardless of when the injury was discovered, subject to limited exceptions.
Ohio also requires most medical malpractice complaints to include an affidavit of merit under Ohio Civil Rule 10(D)(2), confirming that a qualified expert has reviewed the case and believes it has merit.
Because of these strict requirements, families should take the following steps as soon as possible rather than waiting to see how a child's condition develops:
- Request a complete copy of the labor and delivery medical records, including fetal monitoring strips
- Note the exact date of the delivery and any suspected act of malpractice, since this starts Ohio's one-year filing clock
- Avoid waiting to see how the child's condition progresses before seeking legal advice
- Consult a birth injury attorney who can arrange a qualified expert review to support an affidavit of merit
- Keep records of the child's diagnoses, treatments, and any related medical expenses
Beausay Law Firm is Here to Help
Beausay Law Firm has represented Ohio families in some of the state's most serious birth injury cases. Our attorneys have obtained a $2.8 million settlement for a baby who suffered birth asphyxia and cerebral palsy after caregivers failed to respond to a non-reassuring fetal monitoring strip, along with a $2.25 million settlement involving a baby who suffered permanent brain damage from oxygen deprivation before delivery.
Together, our medical malpractice attorneys represent families throughout Ohio, and we handle every consultation personally rather than passing clients off to case managers.
If your family is dealing with a birth injury and you have questions about whether the standard of care was met during labor and delivery, Beausay Law Firm is available to review your case. Contact us for a free, no-obligation consultation to discuss what happened and the legal options available to you.
Disclaimer: The information on this page is provided for general educational purposes only and does not constitute legal advice. Every case is different. Past results do not guarantee future outcomes.
