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Objective: to develop juridical recommendations in order to avoid midwifery medical liability when providing intrapartum care., Design: case law of the past 40 years concerning midwifery medical negligence when assisting labour/delivery in a hospital was analysed. Databases used were Jura and Judit (Belgium), Legifrance, Juricaf and Dalloz (France) and Recht, Rechtspraak (The Netherlands). A minority of cases were retrieved through contacts with insurance companies (only Belgium), lawyers and courts., Setting: law suits in Belgium, France and The Netherlands., Findings: the 100 analysed cases could be categorised into four types. The judicial assessment was focused on three domains of expertise of the midwife. Most cases involved interpreting fetal monitoring (47%), followed by recognising a specific pathology (32%) and responding to a complication (12%). A fourth type of case concerned exceeding the boundaries of the legal competencies of the midwife (9%)., Key Conclusions: not identifying fetal distress through fetal monitoring was the most common cause of midwifery liability (15/47), followed by not recognising the symptoms of a pathology (10/32), particularly placental abruption and uterine rupture. Also an inaccurate response to complications (3/12) and evidently exceeding the professional competencies involved midwifery liability., Implications for Practice: achieving cardiotocograph interpretation skills is the first and most important recommendation. In pathologic cases, the midwife should immediately refer to an obstetrician, without any hesitation. The third recommendation is working in a team with the obstetrician. If the midwife has reasonable (evidence-based) doubts about the practice of the obstetrician, she should insist on re-assessment with respect to the boundaries of her competencies. The fourth recommendation concerns practising with knowledge of the client׳s/patient׳s medical record and updating the record with performances and observations. Consciously choosing the type of medical intervention in urgent cases of pathology is the final recommendation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The birth process is crucial for the child's later motor and intellectual development. Abroad review of medical liability proceedings in Belgium, France and The Netherlands shows that the chances of a safe birth can be maximised if four conditions are met. Well-educated midwives and obstetricians with sound expertise in foetal heart rate monitoring is the first condition. The second is recognition of an obstetric risk or pathology. The third condition is making the appropriate choice of medical intervention: instrumental or caesarean delivery. Adequate use of the instruments is the last condition. Not answering to these 'standards of safe birth' can involve the medical liability of the midwife and obstetrician. In accordance with Article 2 of the European Convention on Human Rights, Belgium, The Netherlands and France offer procedural guarantees to the parents of an injured baby to determine the liability.