Was your baby’s fetal growth restriction missed — and could that be medical negligence?

Understanding fetal growth restriction: what normally happens

Fetal growth restriction — often called FGR — is a condition where a baby does not grow at the expected rate inside the womb. Most clinicians define it as a baby whose estimated weight falls below the 10th percentile for their gestational age. That means the baby is smaller than 90 per cent of babies at the same stage of pregnancy.

FGR is not the same as simply having a small baby. The condition usually signals that the placenta — the organ that delivers oxygen and nutrients from the mother to the baby — is not working properly. When the placenta fails to deliver enough nourishment, the baby’s organs, including the brain, can be deprived of what they need to develop.

Proper antenatal care includes regular measurement of the mother’s abdomen, called fundal height measurement, at every visit. Clinicians plot these measurements on a growth chart. A measurement that falls below the expected range — or that stops growing between visits — should trigger a referral for an ultrasound. For more general information about pregnancy monitoring, Healthdirect Australia provides reliable, plain-English guidance.

When things start to go wrong

Not every small baby has FGR. And not every case of FGR leads to harm. But certain signs should prompt a clinician to act quickly. When those signs appear and nobody responds, the risk to the baby rises sharply.

Reduced fetal movements are one of the most important warning signs a mother can report. Research consistently shows that mothers who notice their baby moving less are often right to be concerned. A clinician who dismisses this concern without investigation may be falling below the standard of care.

A common pattern — where care can break down

FGR cases that result in harm often follow a recognisable pattern. The warning signs were present. But the clinical team did not act on them in time. Below are the most common points where care breaks down.

Failure to measure or plot fundal height correctly

Some clinicians skip fundal height measurement or fail to plot the result on a growth chart. Without a chart, a slow-down in growth is invisible. A single measurement that looks acceptable may actually represent a baby who has stopped growing — but nobody notices because no one is tracking the trend.

Failure to refer for ultrasound: Even when measurements raise concern, some clinicians delay or decline to refer for a growth ultrasound. This delay can be critical. Every week a severely growth-restricted baby remains in a failing placental environment increases the risk of brain injury or stillbirth.

Failure to act on abnormal Doppler results: Doppler studies showing absent or reversed blood flow in the umbilical cord are a serious emergency. A baby in this situation may have only days before the placenta fails completely. Some clinical teams receive these results and do not escalate care quickly enough.

Dismissing a mother’s concerns about fetal movement

Mothers who report reduced fetal movements sometimes face dismissal. A clinician might say the baby is “just sleeping” or that movement naturally slows near the end of pregnancy. Neither statement is accurate medical advice. Reduced movements require investigation — not reassurance without examination.

Delayed delivery decision: Deciding when to deliver a growth-restricted baby requires careful clinical judgement. Delivering too early carries risks of prematurity. But waiting too long — when Doppler results are deteriorating — can result in stillbirth or severe brain injury. Some clinical teams delay this decision beyond what the evidence supports.

The Australian Commission on Safety and Quality in Health Care sets national standards for maternity care, including the monitoring and management of high-risk pregnancies. These standards exist precisely because failures in this area cause serious, preventable harm.

Why this matters legally

Every clinician who treats a pregnant woman owes her — and her baby — a duty of care. That means a legal obligation to provide the standard of care that a competent clinician in the same field would have provided in the same circumstances.

Not every bad outcome in pregnancy amounts to negligence. Some babies suffer harm despite excellent care. Pregnancy carries inherent risks, and the law recognises that. But when a clinician fails to follow established monitoring protocols, ignores warning signs, or delays a decision that the evidence clearly demanded, the law may treat that failure as a breach of duty.

The key legal question is not whether something went wrong. It is whether a competent clinician, acting reasonably, would have done something different — and whether that different action would have changed the outcome. For a plain-English overview of how this works, see Reframe Legal — Medical Negligence.

When fetal growth restriction may amount to medical negligence

The NSW Civil Liability Act 2002 sets the legal framework for medical negligence claims in this state. In plain terms, it requires a person claiming negligence to show that the clinician’s conduct fell below the standard of a reasonable clinician in the same field — and that this failure caused measurable harm.

Several specific failures in FGR cases may meet this threshold. If a midwife measured fundal height at every visit but never plotted the results on a growth chart, and the baby later suffered harm from undetected growth restriction, that omission may constitute a breach. If an obstetrician received Doppler results showing absent end-diastolic flow and waited another two weeks before acting, that delay may be indefensible.

Similarly, if a mother reported reduced fetal movements on multiple occasions and a clinician dismissed her each time without investigation — and the baby was later stillborn or suffered brain injury — the law may treat that dismissal as a failure to meet the required standard. The question is always whether a competent clinician would have acted differently, and whether that different action would have changed what happened to the baby.

When harm becomes long-term or permanent

The harm from missed or mismanaged FGR does not always end at birth. For many families, the consequences unfold over years — sometimes over a lifetime.

• 1
  At birthA severely growth-restricted baby may require resuscitation, intensive neonatal care, and treatment for low blood sugar, low body temperature, and breathing difficulties.
• 2
  First monthsFeeding difficulties, slow weight gain, and developmental delays may emerge. Some babies show early signs of neurological injury, including poor muscle tone and abnormal reflexes.
• 3
  Early childhoodCognitive delays, speech and language difficulties, and learning disabilities may become apparent. Some children receive diagnoses of cerebral palsy linked to oxygen deprivation before birth.
• 4
  School years and beyondChildren with brain injuries from FGR may require specialist education, ongoing therapy, and long-term medical support. Parents often reduce or abandon paid work to provide care.
• 5
  Lifelong impactIn severe cases, a child may never live independently. The financial and emotional cost to the family — and to the child — continues for decades.

Parents in this situation also carry significant psychological harm. Grief, post-traumatic stress, and anxiety are common. Many describe a profound sense of loss — not just for what happened, but for the future they had imagined for their child.

What compensation can cover in fetal growth restriction cases

NSW law allows families affected by medical negligence to seek compensation for a range of losses. This includes pain and suffering, the cost of past and future medical treatment, lost income — both the child’s future earning capacity and the parent’s lost wages — and the cost of ongoing care and support.

In cases involving a child with permanent disability, compensation amounts can be substantial. Courts calculate the cost of a lifetime of care, therapy, and lost opportunity. These figures reflect the real, long-term impact of the harm — not a symbolic payment.

Each case is assessed on its own facts. These figures are general ranges only. In FGR cases involving permanent brain injury or cerebral palsy, total compensation — including future care costs — can reach into the millions.

Time limits apply in NSW. Generally, a person has three years from the date they knew — or ought reasonably to have known — about the negligence to bring a claim. For children, different rules apply. Acting promptly preserves your options.

Bringing it together — do the pieces fit?

You may be reading this because something happened during your pregnancy or your baby’s birth that has left you with unanswered questions. The pieces may not yet form a clear picture. That is normal. Most people in this situation do not know whether what happened to them was negligence — they only know that something felt wrong.

Connecting these questions to a legal framework is the next step. Reframe Legal — How Medical Negligence Claims Work in NSW explains the process in plain language, from gathering records to understanding what a claim involves.

You don’t need certainty to understand your position

Many parents who experienced a difficult pregnancy or birth outcome spend years wondering whether they should have done something sooner. Self-doubt is common. So is the fear of being wrong, or of seeming ungrateful for the care that was provided.

But legal clarity does not require certainty. It requires facts. Medical records, ultrasound reports, Doppler results, and clinical notes all tell a story. A lawyer with expertise in medical negligence reads that story against the standard of care — and identifies whether the gap between what happened and what should have happened is legally significant.

Consent is also a relevant issue in some FGR cases. If a clinician did not explain the risks of continuing the pregnancy or the option of early delivery, that failure may itself be legally significant. Reframe Legal — Informed Consent and Medical Negligence explains how consent failures can form part of a negligence claim.

If you have concerns about the conduct of a specific clinician, AHPRA — Australian Health Practitioner Regulation Agency handles complaints about registered health practitioners in Australia. A complaint to AHPRA is separate from a legal claim and does not affect your right to pursue compensation.

About the lawyer behind this article

This article is general legal information only. It does not constitute legal advice. Each person’s circumstances are different. The law discussed applies to New South Wales, Australia. Time limits apply to legal claims.