The American College of Obstetricians and Gynecologists (ACOG)

This survey, similar to those in 1983, 1985, 1987, 1990, 1992, 1996, 1999, and 2003, addresses the impact that professional liability is having on the practice of obstetrics and gynecology.

Selected data as reported in ACOG Clinical Review, March-April 2007

• 8,294 respondents
• 77.7 percent provide both obstetrics and gynecological care
• Average doctor performed 11.4 NSD, 0.8 VBAC and 4.3 C/S per month
• 89.2 percent respondents had at least one professional liability claim during their career or an average of 2.62 claims per OB/GYN doctor
• 62.1 percent were obstetrical claims
• 37.9 percent were gynecological claims
• 67.4 percent of claims were dropped or settled on behalf of the OB/GYN doctor
• 20.1 percent settlement and payment in advance of trial
• 10.2 percent payment after jury or court verdict
• 3.4 percent payment after alternative dispute mechanism
• Family practice doctors were named as co-defendants in 2.9 percent of claims
• Nurse-midwives were named as co-defendant in 3.8 percent of claims
• Nurses were named as co-defendants in 12 percent of claims
• Ob/gyn residents were named as co-defendants in 15 percent of claims

Findings from 4,184 obstetrical claims

• Neurologically impaired infant (30.8 percent)
• Average payment for these claims was $1,150,687
• Stillbirth/Neonatal death (15.8 percent)
• Shoulder Dystocia or Brachial Plexus Injury associated with 15.7 percent of claims
• 10.9 percent of claims involved EFM
• Respondents named actions of non-MD providers as factor in 5.8 percent claims
• Respondents named actions of ob/gyn residents as factor in 8.6 percent of claims

Practice change	Reason: affordability and availability of insurance	Reason: fear of liability claims or litigation
Stop obstetrical practice	7.2%	8.3%
Increase in cesarean deliveries	28.5%	37.1%
Decrease in deliveries	11.7%	14.5%
Discontinue VBAC	26.4%	32.7%
Decrease no. of high-risk obstetric patients	25.6%	33.1%
Decrease gyn surgical procedures	12.6%	16.4%
Stop major gyn surgery	4%	4.9%
Stop all surgery	2.1%

For more information on the Obstetric Safety Initiative, or to offer suggestions for this site, contact us.