This blog is co-authored by Raaiqhah Akoo, a candidate attorney.
In June 2025, the High Court found the MEC for the Department of Health, Limpopo liable for the omissions and acts of the healthcare staff at a public hospital who delivered a baby by natural vaginal delivery despite the baby presenting in the breech position.
The claimants’ main claim was for the brain and other injuries allegedly suffered by the baby due to the healthcare staff failing to correctly diagnose the breech presentation of the baby timeously and to expedite delivery by caesarean section. The baby, who was delivered naturally, was stillborn and had to be resuscitated. The baby suffered hypoxic ischemic injury to his brain and consequent related injuries.
The MEC’s defence on the main claim was that by the time that the attending doctor determined that the baby was in the breech position, the feet of the baby were out and, therefore, it was too late to deliver by caesarean section.
The claimants’ expert obstetrician testified that in a breech presentation, the problem is that the baby’s feet are delivered first, leading to the head being stuck in the vagina and being subject to compression. This is what causes the potential complications to the baby. In the expert’s opinion, even when the baby’s feet can be observed during the labour, delivery by caesarean section can still be performed and is advisable specifically to avoid a situation where the baby’s head may be stuck, causing asphyxiation.
The claimant’s expert further testified that if the baby’s breech position was determined when the mother was assessed on admission to the hospital, the doctor would have been called immediately, and a caesarean section would have been done shortly thereafter. The suggestion that a delivery by a caesarean section was no longer available due to the baby’s feet showing was incorrect. The caesarean section would not be available only once the torso was out and only the head remained inside the mother.
The court decided that the baby’s injuries and consequent damages were caused by birth asphyxia, which could have been avoided had the healthcare staff correctly and timeously diagnosed the breech presentation and taken the prescribed corrective procedures to deal with the presentation. If the baby was delivered by caesarean section, his head would not have been stuck in the delivery canal and, as a result, he would not have been born with any complications or adverse consequences. The actions of the healthcare staff fell short of what can be reasonably expected from healthcare practitioners in their position and was negligent.
This judgment illustrates the importance of proper assessments of mothers and babies during labour, and timeous intervention, in accordance with the healthcare guidelines, when complications arise during labour and delivery.