Was a haematoma in your placenta missed or mismanaged — and could that be medical negligence?

Understanding a haematoma in the placenta: what normally happens

A placental haematoma is a collection of blood that forms between the placenta and the wall of the uterus, or between the placenta and the membranes surrounding the baby. The placenta is the organ that connects the baby to the mother’s blood supply and delivers oxygen and nutrients. When blood pools in or around it, the placenta may not work properly.

There are different types. A subchorionic haematoma forms between the placenta and the outer membrane. A retroplacental haematoma forms behind the placenta, between it and the uterine wall. Retroplacental haematomas are generally considered more serious because they can disrupt blood flow to the baby more directly.

When a haematoma is suspected — usually because a pregnant person reports vaginal bleeding, pelvic pain, or cramping — the standard response is to perform an ultrasound. That scan should identify whether a haematoma is present, where it is, and how large it is. The treating team should then explain the findings, discuss the risks, and put a monitoring plan in place. Depending on the size and location, that plan may involve rest, repeat scans, hospitalisation, or in serious cases, early delivery.

For more information about placental conditions during pregnancy, see Healthdirect — Placenta problems.

When things start to go wrong

Not every haematoma causes serious harm. Small subchorionic haematomas often resolve without intervention. But larger haematomas, or those that grow over time, carry real risks — including miscarriage, placental abruption, preterm birth, and restricted growth in the baby.

The problem is not always the haematoma itself. The problem is often what happens — or does not happen — after it is discovered. Or when it is not discovered at all.

These are red flags that suggest care may not have met the expected standard:

• Vaginal bleeding was reported but no ultrasound was arranged
• An ultrasound was done but the haematoma was not identified or documented
• A haematoma was found but the patient was not told about it
• No follow-up scan was scheduled after a haematoma was detected
• Symptoms worsened and repeated presentations were dismissed
• Signs of placental abruption — where the placenta separates from the uterine wall — were not acted on quickly
• The baby showed signs of distress on monitoring but delivery was delayed
• A stillbirth or neonatal death occurred after earlier warning signs were not escalated

A common pattern — where care can break down

Across cases involving placental haematomas, certain failures appear again and again. Understanding these patterns can help you recognise what may have happened in your own situation.

Bleeding dismissed as normal spotting. Early pregnancy bleeding is common, and many practitioners reassure patients without ordering imaging. But when bleeding is heavy, persistent, or accompanied by pain, dismissing it without investigation can be a failure of care. A haematoma that is missed at this stage may grow significantly before it is detected.

Ultrasound not ordered promptly. Ultrasound is the primary tool for identifying a placental haematoma. When a patient presents with symptoms and a scan is delayed by days or weeks, a growing haematoma may cause harm that earlier detection could have prevented or reduced.

Haematoma found but not properly communicated. Sometimes a scan identifies a haematoma but the result is not clearly explained to the patient. The patient may not know they have a high-risk condition, may not understand the warning signs to watch for, and may not know to return urgently if symptoms change. This is a failure of informed consent — the legal and ethical obligation to give patients the information they need to make decisions about their care.

No monitoring plan after diagnosis. A haematoma that is identified but then left unmonitored is a serious concern. The standard of care requires regular follow-up scans to track whether the haematoma is growing, stable, or resolving. Without this, deterioration can go undetected.

Failure to refer to a specialist. General practitioners and midwives play an important role in antenatal care, but a large or retroplacental haematoma may require review by a maternal-fetal medicine specialist — a doctor who focuses on high-risk pregnancies. Failure to refer when the situation warrants it can delay appropriate management.

Delayed response to placental abruption. Placental abruption is a medical emergency where the placenta separates from the uterine wall before birth. It can cause severe bleeding, oxygen deprivation to the baby, and death. When a haematoma is present and abruption signs appear — sudden severe pain, heavy bleeding, changes in fetal heart rate — the response must be immediate. Delay in this context can be catastrophic.

The Australian Commission on Safety and Quality in Health Care sets out the standards that health services in Australia are expected to meet, including how patients must be informed and how clinical deterioration must be recognised and escalated.

Why this matters legally

Duty of care is the legal obligation that a health professional has to act with reasonable skill and care when treating a patient. Every doctor, midwife, and hospital that provides antenatal care owes a duty of care to both the pregnant person and the unborn child.

It is important to understand that not every bad outcome in pregnancy is negligence. Pregnancy carries inherent risks. Some haematomas cause harm even when care is excellent. The law does not require perfection. It requires that the care provided met the standard of a reasonably competent practitioner in the same field.

What the law asks is this: did the health professional do what a reasonable practitioner in their position would have done? If a haematoma was missed because no scan was ordered when one should have been, or if a known haematoma was left unmonitored when monitoring was clearly required, the answer to that question may be no.

Reasonable care in this context means recognising warning signs, ordering appropriate investigations, communicating findings clearly, monitoring known risks, escalating when things change, and acting without unreasonable delay when the situation demands it.

For a broader overview of how medical negligence law works in Australia, visit Reframe Legal — Medical Negligence.

When a haematoma in the placenta may amount to medical negligence

The NSW Civil Liability Act 2002 is the main law that governs personal injury claims in New South Wales, including medical negligence claims. It sets out the rules for proving that a health professional’s conduct fell below the required standard and caused harm.

Under that framework, the following situations may give rise to a negligence claim:

If you reported bleeding and no scan was arranged. Vaginal bleeding in pregnancy is a recognised warning sign. Failing to investigate it with an ultrasound — particularly in the second or third trimester — may fall below the standard expected of a competent practitioner.

If a haematoma was identified but you were not told about it. Patients have a right to know about findings that affect their health and their baby’s health. Withholding or failing to communicate this information may breach the duty of informed consent.

If a large or growing haematoma was not monitored with repeat scans. A haematoma that is documented but then ignored — with no follow-up imaging and no management plan — may represent a failure to provide appropriate ongoing care.

If signs of placental abruption were present and delivery was delayed. When a haematoma progresses to abruption, time is critical. Delay in performing an emergency caesarean section in the face of clear signs of fetal distress may cause brain injury or death that timely delivery could have prevented.

If a stillbirth followed repeated dismissed presentations. When a patient presents multiple times with worsening symptoms and is repeatedly sent home without investigation, and a stillbirth then occurs, the question of whether earlier action would have changed the outcome becomes central to a legal assessment.

When harm becomes long-term or permanent

The consequences of a missed or mismanaged placental haematoma can extend far beyond the pregnancy itself.

Physical consequences may include the loss of a baby through miscarriage or stillbirth, a baby born with hypoxic-ischemic encephalopathy (brain injury caused by oxygen deprivation), cerebral palsy, developmental delays, or lifelong disability. For the mother, consequences may include severe haemorrhage, emergency hysterectomy, or long-term complications from emergency surgery.

Psychological consequences are profound and often underestimated. Grief after pregnancy loss is not the same as ordinary grief. Many parents experience post-traumatic stress disorder, depression, anxiety, and complicated grief that affects their relationships, their ability to work, and their capacity to engage in daily life for years. Parents of a child born with a disability may carry the weight of that grief alongside the ongoing demands of caring for a child with complex needs.

Financial consequences accumulate over time. A child with cerebral palsy or significant developmental delay may require specialist therapies, modified housing, assistive technology, and full-time care for decades. Parents may reduce their working hours or leave employment entirely to provide that care. The lifetime cost of supporting a child with severe disability can run into the millions of dollars.

What compensation can cover in placental haematoma cases

In New South Wales, compensation in a medical negligence claim can cover pain and suffering, loss of income, past and future medical treatment costs, the cost of care and assistance, and in cases involving a child with disability, the cost of that child’s ongoing support needs.

Each case is assessed on its own facts. These figures are general ranges only.

It is important to know that time limits apply in NSW. In most cases, a claim must be started within three years of the date the person knew — or ought reasonably to have known — that they had a potential claim. In cases involving children, different rules may apply. Acting within the time limit is essential.

Bringing it together — do the pieces fit?

Understanding whether what happened to you may amount to negligence starts with asking some honest questions about your care. You do not need to be a medical expert to ask them. You just need to think carefully about what occurred.

Consider these questions:

• Did you report bleeding, pain, or other symptoms — and were they taken seriously?
• Was an ultrasound arranged promptly, or was it delayed or refused?
• Were you told about a haematoma, or did you only find out later — or not at all?
• Was a monitoring plan put in place, or were you simply sent home?
• Did you return with worsening symptoms and feel dismissed?
• Did your baby suffer harm — brain injury, disability, or death — after warning signs were present?
• Did you feel that something was wrong before the outcome occurred, but nobody listened?

If you answered yes to several of these, there may be a gap between the care you received and the care you were entitled to. That gap is what a legal assessment examines.

To understand how the claims process works from start to finish, visit Reframe Legal — How Medical Negligence Claims Work in NSW.

You do not need certainty to understand your position

Many people who have experienced a traumatic pregnancy outcome spend months — sometimes years — wondering whether what happened was their fault, or whether they should have pushed harder, or whether they are simply unlucky. Self-doubt is a natural response to grief and trauma. It does not mean your concerns are unfounded.

The law does not require you to be certain that negligence occurred before you seek to understand your position. Legal clarity comes from examining the facts — the medical records, the scan reports, the clinical notes, the timing of decisions — not from how confident you feel right now.

It is also worth knowing that you have the right to understand what happened to you. You can request your medical records. You can ask for an explanation. You can seek an independent opinion. None of these steps commit you to any particular course of action. They simply give you information.

If you were not properly informed about your haematoma, its risks, or your options, that may itself be a legal issue. 

If you want to understand how complaints about health practitioners are handled in Australia, you can also visit AHPRA — How we handle notifications about practitioners. AHPRA is the Australian Health