Pregnancy is naturally a time of hope and anticipation, but it is also a period that requires vigilant medical monitoring. One of the most critical conditions that maternity teams in Ireland must screen for is Gestational Diabetes Mellitus (GDM).
When managed correctly by the HSE or private consultants, gestational diabetes is a treatable condition that usually results in a healthy mother and baby. However, when medical professionals fail to screen for, diagnose, or manage this condition, the consequences can be devastating.
If you believe your child suffered a birth injury,such as Shoulder Dystocia, Erb’s Palsy, or Cerebral Palsy,because your gestational diabetes was missed or mishandled, you are looking for answers.
At Michael Boylan LLP, we understand that no amount of money can undo a traumatic birth. However, a successful medical negligence claim can secure the lifetime of care, therapy, and support your child deserves.
What Is Gestational Diabetes Negligence?
Gestational diabetes is a type of diabetes that develops during pregnancy when the mother’s body cannot produce enough insulin to meet the extra needs of pregnancy. This results in high blood sugar levels (hyperglycaemia), which can pass through the placenta to the baby.
In Irish medical negligence law, a diagnosis of gestational diabetes itself is not grounds for a claim. It is a naturally occurring condition in some pregnancies.
Negligence occurs when there is a breach of duty. This means the standard of care provided by your obstetrician, midwife, or GP fell below what is accepted as reasonable by a competent body of medical professionals in Ireland.
GDM negligence typically arises in three specific ways:
- Failure to Screen: This is when the medical team ignored risk factors and failed to perform a glucose tolerance test (GTT).
- Failure to Monitor: The condition was diagnosed, but blood sugar levels were not tracked, or medication (like Metformin or Insulin) was not prescribed when diet alone failed.
- Failure to Manage Delivery: The team failed to anticipate the size of the baby (macrosomia), leading to a dangerous vaginal delivery instead of a planned Caesarean section.
If any of these failures led to an injury to you or your child, you may have a valid claim for medical negligence.
How Failure to Diagnose Gestational Diabetes Happens
The HSE National Clinical Guidelines provide clear protocols on how maternity units should handle diabetes in pregnancy. When these protocols are bypassed due to understaffing, lack of training, or administrative error, patients suffer.
Missed Screening & The Glucose Tolerance Test (GTT)
In Ireland, not every pregnant woman is automatically tested for diabetes. Instead, many hospitals use selective screening based on risk factors. A major source of negligence claims is a situation where a mother has clear risk factors that are noted on her file but ignored.
Medical professionals should offer a GTT, typically between 24 and 28 weeks, if you have any of the following risk factors:
- Body mass index (BMI) above 30 kg/m².
- Previous large baby (weighing 4.5kg or more).
- Family history of diabetes (first-degree relative).
- Ethnicity with a high prevalence of diabetes (e.g., South Asian, Black Caribbean, or Middle Eastern background).
- Previous gestational diabetes in a prior pregnancy.
If these risks were detected but you were never sent for a GTT, and your baby subsequently suffered an injury related to high blood sugar, this is a primary indicator of negligence.
Misinterpretation of Test Results
Interpreting the results correctly is equally vital. Sometimes, a borderline result is dismissed as “normal” when it actually requires intervention.
Furthermore, negligence can occur regarding urine glucose testing. At every antenatal appointment, your urine should be dipped to check for sugar (glycosuria). If sugar is repeatedly found in your urine and the medical team fails to investigate further with blood tests, they have missed a critical red flag.
Failure to Plan for a Safe Delivery
The most dangerous consequence of uncontrolled gestational diabetes is macrosomia,a medical term for a "big baby" (usually defined as over 4kg or 4.5kg).
When a mother has high blood sugar, the baby essentially receives a continuous supply of sugar, which triggers the baby’s body to produce excess insulin. Insulin acts as a growth hormone, causing the baby to grow excessively large, particularly in the upper body and shoulders.
If a medical team knows (or should know) a mother has gestational diabetes, they must monitor the baby's growth via ultrasound. If the baby is measuring large, a safe delivery plan must be discussed.
- Induction of Labour: Bringing the birth forward before the baby grows too large.
- Elective Caesarean Section: Avoiding a vaginal birth entirely to prevent the baby from getting stuck.
If the team insists on a natural delivery for a diabetic mother with a known large baby, and the baby becomes stuck, the resulting injuries are often deemed avoidable.
The Impact of Negligence: Injuries to Mother and Baby
The tragedy of gestational diabetes negligence is that the injuries are frequently permanent and life-altering. The damage is rarely limited to a single moment. It can require a lifetime of rehabilitation.
Risks to the Mother
While the focus is often on the child, the mother can suffer severe physical and psychological trauma due to the delivery of an unexpectedly large baby.
- Perineal Tearing (3rd and 4th Degree Tears): Severe tearing of the vaginal wall and anal sphincter, often leading to long-term incontinence and the need for reconstructive surgery.
- Uterine Rupture: A catastrophic event where the uterus tears during labour, posing a risk of death to both mother and baby.
- Post-Traumatic Stress Disorder (PTSD): A traumatic birth experience caused by emergency interventions (such as forceps or vacuum extraction) can lead to lasting psychological injury.
- Future Type 2 Diabetes: While GDM usually resolves after birth, mothers are at higher risk of developing Type 2 diabetes later in life. If the GDM was never diagnosed, the mother loses the opportunity for early lifestyle interventions to prevent this.
Risks to the Baby
The most severe claims handled by Michael Boylan LLP involve injuries to the infant.
1. Shoulder Dystocia
This is a terrifying obstetric emergency where the baby’s head is delivered, but one or both shoulders become stuck behind the mother’s pubic bone.
If the doctor or midwife panics and pulls too hard on the baby's head (excessive traction) to free them, they can stretch or tear the nerves in the baby's neck.
If the macrosomia had been identified, a C-section could have avoided this scenario entirely.
2. Erb’s Palsy (Brachial Plexus Injury)
This is the direct result of mishandled Shoulder Dystocia. It involves damage to the Brachial Plexus nerves that control the arm and hand.
- Temporary: Some babies recover movement with physiotherapy.
- Permanent: In severe cases, the nerves are avulsed (torn from the spine), leaving the child with a permanently paralysed or “withered” arm. This affects their ability to dress, play, work, and live independently.
3. Hypoglycaemia (Low Blood Sugar) & Brain Injury
Babies born to mothers with uncontrolled diabetes are used to high sugar levels. Once the umbilical cord is cut, their sugar supply stops, but their pancreas continues producing high levels of insulin.
This causes their blood sugar to crash (neonatal hypoglycaemia).
- The Danger: If this is not treated immediately with glucose feeds or an IV drip, it can cause seizures and permanent brain damage.
- Cerebral Palsy: Prolonged hypoglycaemia is a known cause of cerebral palsy. Unlike CP caused by oxygen deprivation, this type of CP is often entirely preventable with simple blood tests after birth.
Proving Medical Negligence in Gestational Diabetes Cases
Medical negligence cases in Ireland are complex. It is not enough to show that something went wrong; we must prove that the error was negligent and that it directly caused the injury.
At Michael Boylan LLP, we approach this by building a robust case on three pillars:
1. Establishing Breach of Duty
We will obtain your medical records and have them reviewed by independent obstetric and midwifery experts. We ask:
- Did the hospital follow the HSE guidelines for diabetes screening?
- Was the growth of the baby monitored?
- Were you informed of the risks of vaginal delivery versus C-section? You have a legal right to know the risks of a vaginal delivery versus a Caesarean section, especially if your baby is large. If these risks were not explained to you, you may not have given informed consent for the delivery method used.
2. Proving Causation
This is often the most contested area. We must prove that “but for” the negligence, the injury would not have occurred.
- Example: If the GDM had been treated, the baby would not have grown so large.
- Example: If a C-section had been performed, the Shoulder Dystocia (and resulting Erb’s Palsy) would never have happened.
3. Quantifying Damages (The Value of the Claim)
If liability is established, we then calculate the value of the claim. In Irish law, this is not a windfall, but a calculation of the specific funds a child requires to live as normal a life as possible.
- General Damages: Compensation for the pain and suffering caused by the injury.
- Special Damages: This covers financial costs incurred or likely to be incurred in the future. Depending on the child's needs, this may include the cost of future care, home adaptations, assistive technology, therapy, and loss of future earnings.
Why Choose Michael Boylan LLP?
When seeking legal advice for gestational diabetes negligence, it is vital to engage a firm with specific experience in complex litigation and clinical issues.
Medical and Legal Knowledge
Michael Boylan LLP is a specialist litigation firm. What sets us apart is the composition of our team, which includes solicitors working alongside in-house medical consultants.
- For gestational diabetes claims, this allows us to analyse complex maternity records and glucose tolerance test (GTT) results with precision.
- We can efficiently determine if the standard of care provided to you fell below the acceptable medical guidelines.
Established Experience in Medical Law
Our partners have a long history of managing high-value and complex cases in the High Court. This includes involvement in landmark decisions such as Dunne v The National Maternity Hospital, which set the legal standard for medical negligence in Ireland.
We are accustomed to managing proceedings against the HSE and the State Claims Agency, ensuring that families have the robust representation required for challenging cases.
Transparent and Empathetic Support
We understand that pursuing a claim involving a child’s health can be daunting. We prioritise a client-focused approach, ensuring that you are kept informed at every stage of the process. We will explain the legal journey in plain English, helping you to make informed decisions for your family’s future.
Frequently Asked Questions
Is there a time limit for making a claim?
Yes, but it depends on who is filing the claim. For a child, the clock does not begin ticking until they turn 18. This means they have until their 20th birthday to bring a claim. However, we strongly advise parents to start the process as soon as possible while medical records and memories are fresh. For a mother claiming for her own injuries (e.g., tears or PTSD), the limit is generally two years from the date of the negligence.
I had gestational diabetes, but my baby is fine. Can I still claim?
Generally, no. Medical negligence law in Ireland requires you to have suffered an injury or loss due to the negligence. If the hospital failed to diagnose you, but you and your baby remained healthy by chance, there is usually no case because there is no damage to compensate you for.
Will making a claim affect my child’s medical care?
No. Your child is entitled to public medical care regardless of any legal action. In fact, a successful claim often allows you to access private care, specialist therapies, and equipment that the public system cannot provide, improving your child's quality of life.
How do I know if my baby's injury was caused by diabetes?
This is where our experts come in. If your baby was born weighing more than 4kg (macrosomia) and suffered a shoulder injury (Erb's Palsy) or low blood sugar seizures, there is a strong possibility it is linked to undiagnosed or poorly managed diabetes. We can investigate the link for you.
What does it cost to investigate a claim?
At Michael Boylan LLP, we understand the financial burden families face. We offer an initial consultation to assess the viability of your case. If we believe you have a strong case, we will discuss fee arrangements that ensure you can pursue justice without upfront financial stress.
Take the Next Step for Your Family
If you suspect that a failure to diagnose or manage gestational diabetes has altered the course of your child’s life, do not suffer in silence. The questions keeping you up at night deserve answers.
At Michael Boylan LLP, we have the expertise to uncover the truth and the tenacity to secure your family's future.
Contact us today for a confidential discussion.
*In contentious business, a solicitor may not calculate fees or other charges as a percentage or proportion of any award or settlement.
