Military Facilities Ordered to Improve Maternity and Post-Partum Care

United States Secretary of Defense Chuck Hagel issued a direct order to all branches of the military in October, 2014, demanding increased safety measures, reduced patient trauma and more accessible military medical facilities for patients in need.

The order came on the heels of a revealing study performed by Pentagon officials into the above-average number of patient problems and issues at military facilities – especially pertaining to maternity and post-partum care. The 645-page Military Health System Review revealed a number of startling figures, prompting Secretary Hagel to demand immediate changes by the end of year. Secretary Hagel commended military health professionals for their “selfless work and efforts,” particularly with regard to combat trauma care. However, for those seeking maternal care, childbirth assistance or post-partum treatment, these patients are unfortunately in a category showing complication statistics exceeding the national averages.

Issues giving rise to possible military hospital malpractice

Malpractice occurs when a doctor or medical professional deviates from the accepted medical standards in a particular community. If the deviation results in trauma, injury or death to the patient that would not have occurred but for the mistake, the patient or her family may initiate a medical malpractice or wrongful death lawsuit. The standard of care in a particular medical situation is generally determined by inquiring into what is “reasonable” in light of all the factors at work.

In today’s military hospitals, the MHS Review points to a number of issues impacting pregnant and laboring women, including an increased use of the controversial forceps or vacuum extraction method in response to fetal shoulder dystocia. In fact, one figure provided in the MHS Report showed a steady increase of shoulder dystocia over the past several years and, in each year, the rate of dystocia occurring in military hospital deliveries exceeding those instances occurring in the overall civilian population. Moreover, instances of post-partum hemorrhage remain well above the national civilian average, which has stayed constant over the past several years.

Other concerning maternal issues include an higher rate of infant readmission within 42 days post-partum and a birth trauma rate of 0.4 percent in military hospitals as opposed to 0.2 percent in the United States overall. Infant birth trauma in military hospitals, which is often preventable with proper prenatal care and monitoring during labor, is further broken down as follows:

• Epicranial hemorrhage: 16%
• Subdural or cerebral hemorrhage: 8%
• Facial nerve injury: 8%
• Skeletal injuries: 5%
• Peripheral nerve injury: 1%
• Other specified birth trauma: 65%

Fortunately, the rate of infant mortality is much lower at military medical facilities as compared with the national average, and has shown no signs of increasing over the past four years. Also, the results of the review revealed that military hospitals carry a lower rate of Caesarian deliveries as opposed to the overall national average.

As a result of the findings, the Military Health System has been instructed to review and investigate its perinatal services in the lacking areas, including a comprehensive review of the major areas in which MHS services are underperforming.