A nationwide descriptive study of obstetric claims for compensation in Norway

Acta Obstet Gynecol Scand. 2012 Oct;91(10):1191-5. doi: 10.1111/j.1600-0412.2012.01409.x. Epub 2012 Aug 13.


Objective: To describe causes of substandard care in obstetric compensation claims.

Design and setting: A nationwide descriptive study in Norway.

Population: All obstetric patients who believed themselves inflicted with injuries by the Health Service and applying for compensation.

Methods: Data were collected from 871 claims to The Norwegian System of Compensation to Patients during 1994-2008, of which 278 were awarded compensation.

Main outcome measures: Type of injury and cause of substandard care.

Results: Of 871 cases, 278 (31.9%) resulted in compensation. Of those, asphyxia was the most common type of injury to the child (83.4%). Anal sphincter tear (29.9%) and infection (23.0%) were the most common types of injury to the mother. Human error, both by midwives (37.1% of all cases given compensation) and obstetricians (51.2%), was an important contributing factor in inadequate obstetric care. Neglecting signs of fetal distress (28.1%), more competent health workers not being called when appropriate (26.3%) and inadequate fetal monitoring (17.3%) were often observed. System errors such as time conflicts, neglecting written guidelines and poor organization of the department were infrequent causes of injury (8.3%).

Conclusions: Fetal asphyxia is the most common reason for compensation, resulting in large financial expenses to society. Human error contributes to inadequate health care in 92% of obstetric compensation claims, although underlying system errors may also be present.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Injuries / economics
  • Birth Injuries / etiology
  • Compensation and Redress*
  • Delivery, Obstetric / adverse effects*
  • Delivery, Obstetric / economics
  • Delivery, Obstetric / legislation & jurisprudence
  • Delivery, Obstetric / standards
  • Female
  • Guideline Adherence
  • Humans
  • Infant, Newborn
  • Medical Errors / economics
  • Medical Errors / legislation & jurisprudence*
  • Medical Errors / statistics & numerical data
  • Norway
  • Obstetrics and Gynecology Department, Hospital / legislation & jurisprudence*
  • Obstetrics and Gynecology Department, Hospital / standards
  • Obstetrics and Gynecology Department, Hospital / statistics & numerical data
  • Practice Guidelines as Topic
  • Pregnancy
  • Puerperal Disorders / economics
  • Puerperal Disorders / etiology
  • Quality Improvement
  • Standard of Care