After a diagnosis of hypoxic ischemic encephalopathy, one of the most common and most difficult questions parents ask is: “Could this have been prevented?”
This question is not about blame. It is about understanding what happened during labor and delivery and whether earlier recognition or intervention could have reduced the risk of injury.
IS HIE ALWAYS PREVENTABLE?
No. Some cases of HIE occur despite appropriate and timely medical care. Pregnancy and birth can be unpredictable, and not every complication can be avoided.
However, other cases involve patterns that raise questions about whether warning signs were missed, whether labor was managed appropriately, or whether critical decisions were delayed.
Understanding the difference requires a careful review of the medical record.
WHEN QUESTIONS ABOUT PREVENTABILITY OF HIE ARISE
Parents often begin to question preventability when they recall events such as:
• Repeated concerns about the fetal heart rate during labor
• Long periods of labor without progress
• Escalating doses of Pitocin despite signs of distress
• Delays in moving to a cesarean delivery
• Statements like “let’s wait and see” as conditions worsened
These experiences do not automatically mean that medical care was improper. But they are often the types of situations that warrant closer examination.
WHAT MEDICAL RECORDS HELP DETERMINE PREVENTABILITY?
Determining whether HIE may have been preventable usually involves reviewing:
• Continuous fetal heart monitoring strips
• Nursing and physician notes
• Timing of medications such as Pitocin
• Labor progression and decision points
• The decision-to-delivery interval if a C-section occurred
• Cord blood gas results
A discharge summary alone rarely answers these questions.
WHY HOSPITAL EXPLANATIONS MAY FEEL INCOMPLETE
Families are sometimes told that HIE is unavoidable or that “sometimes this just happens.” While that may be true in some cases, these statements often do not reflect the full picture shown in the medical records.
Preventability is not determined by reassurance after the fact. It is determined by reviewing what was happening in real time during labor and how the care team responded.
WHAT SHOULD PARENTS DO IF THEY HAVE QUESTIONS?
If you are wondering whether your baby’s HIE could have been prevented, it is reasonable to seek a careful, record-based explanation of what occurred.
A confidential review of the labor and delivery records can help clarify whether the injury was unavoidable or whether there are unanswered questions about care.
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