Prenatal care is designed to identify risks early, monitor growth, and respond to warning signs before they become emergencies. When key indicators are missed or follow-up is delayed, families may face preventable complications. This guide explains common prenatal care errors, what records matter, and how Chicago families can organize questions after a high-risk pregnancy was not identified in time.
What counts as a prenatal care error
A prenatal care error can involve missed risk factors, delayed testing, or failure to act on abnormal results. Not every complication is preventable, but the medical record should show that risks were evaluated, tests were ordered on time, and follow-up care was appropriate.
Families often want to know whether a risk factor was documented and whether the recommended follow-up occurred. A clear record of decisions and timing helps answer those questions.
Common missed high-risk indicators
- High blood pressure or signs of preeclampsia
- Gestational diabetes not diagnosed or poorly managed
- Fetal growth restriction not recognized
- Placenta previa or placental abnormalities not tracked
- Infection symptoms not evaluated or treated
- Reduced fetal movement reports not addressed
These issues can raise the risk of stillbirth, preterm birth, or newborn complications if they are not monitored closely.
If any of these were noted in your chart, ask what additional monitoring was scheduled and whether it happened.
Some patients are told a condition is borderline. In that case, ask how often it should be rechecked and whether additional testing was recommended.
If your provider mentioned a risk but did not schedule follow-up, ask for that recommendation in writing.
Warning signs that should trigger action
- Persistent headaches or vision changes
- Severe swelling or sudden weight gain
- Bleeding or leaking fluid
- Repeated reports of decreased fetal movement
- Abnormal labs or ultrasound findings
If these signs were reported, the record should show what testing was done, what advice was given, and whether follow-up occurred.
If you reported symptoms by phone or through a portal, request those messages. They often show the advice given and the timing of follow-up.
How prenatal testing should be documented
Prenatal care typically includes routine labs, ultrasounds, and screening tests. The chart should show:
- Dates of key ultrasounds and growth measurements
- Glucose screening and diagnostic test results
- Blood pressure readings and urine protein checks
- Notes on fetal movement and kick count guidance
- Any referrals to maternal-fetal medicine
If a test was abnormal, the record should show the follow-up plan and whether it was completed.
Ask for the exact dates of each test. Timing can matter when evaluating whether follow-up was timely.
Missed follow-up after abnormal results
Some of the most serious prenatal care issues involve a test that was abnormal but not followed by appropriate monitoring. Examples include a low growth percentile without repeat imaging, a high blood pressure reading without repeat checks, or a failed glucose screen without a diagnostic test.
The record should show whether follow-up was ordered, whether the patient was notified, and whether the follow-up occurred. If there is a gap, note the dates and ask for an explanation.
Fetal growth restriction and missed red flags
Growth restriction can signal placental problems or other risks. If an ultrasound showed low growth percentiles, the record should show whether additional monitoring was scheduled. Ask for the exact percentile, the dates of each scan, and whether Doppler studies were done.
If growth restriction was suspected but not followed up, that can be a major issue. A clear timeline helps experts evaluate whether the response was timely.
If Doppler studies or biophysical profiles were ordered, ask for the reports and dates. Those studies often guide delivery planning.
Missed preeclampsia or hypertension
Preeclampsia can develop quickly and requires close monitoring. Prenatal records should show blood pressure trends, urine protein results, and any symptoms like headaches or visual changes. If blood pressure readings were high, the chart should show follow-up testing and instructions given to the patient.
If symptoms were reported but not addressed, document the dates and the advice given.
If a home blood pressure log was requested, ask whether it is included in the chart.
Gestational diabetes and follow-up gaps
Gestational diabetes increases risks for both mother and baby. The chart should show glucose screening dates, diagnostic test results, and the plan for monitoring and diet or medication. If diabetes was diagnosed late or not managed, ask for the full lab history and follow-up notes.
If you were referred to a nutritionist or diabetes educator, ask for those notes as well.
Chicago-specific context and referrals
In Chicago, many patients receive prenatal care in clinics and deliver at hospitals with separate systems. If you were seen at multiple clinics, request records from each location. If a referral to maternal-fetal medicine was made, ask for those consult notes.
Transfers between hospitals or late referrals can affect monitoring plans. Note the date of any transfer or referral and compare it to the timeline in the chart.
If your prenatal care and delivery occurred in different systems, request records from both locations to avoid gaps.
If you were told to go to a specific hospital for testing, ask whether those test results were shared back to your main clinic.
If you switched providers during pregnancy, ask for a transfer summary and confirm that key test results were forwarded.
Records and evidence checklist
Request the full prenatal chart, not just summaries.
- All prenatal visit notes and vitals
- Ultrasound reports and growth measurements
- Lab results (glucose, blood pressure, urine protein)
- Notes on reported symptoms and provider responses
- Referral notes and specialist consultations
- Labor and delivery notes and newborn records
Keep a log of what you requested and when you received it. If anything is missing, follow up in writing.
Ask for any maternal-fetal medicine consult letters. They often include risk assessments and monitoring plans.
If you were told that a test was normal, ask for the actual report. It helps confirm what was measured and when.
Ask for any phone triage notes or after-hours call logs related to your symptoms.
How to build a clear timeline
Create a timeline that includes:
- Dates of prenatal visits and tests
- When symptoms were reported
- When abnormal results were documented
- When follow-up testing occurred
- Any changes in the delivery plan
A clear timeline helps specialists evaluate whether care met the expected standard.
Include dates of phone calls, portal messages, and missed appointments. These details can affect how the timeline is understood.
Attach any written instructions you received about when to return or when to seek urgent care.
Recovery and next steps
If your pregnancy ended in a complication, ask your OB for a written summary and follow-up plan. This helps with future pregnancies and specialist care. If your baby has ongoing health needs, keep pediatric records and therapy notes organized.
Emotional recovery matters too. If you feel overwhelmed or anxious, ask your provider for counseling or local support resources.
If you plan a future pregnancy, ask for a preconception visit and a summary of the key risks that should be monitored.
If your baby was in the NICU, keep the NICU discharge summary with your prenatal records. It can help specialists connect prenatal concerns with newborn outcomes.
Early Intervention in Illinois
Illinois Early Intervention provides evaluation and therapy for children from birth to age three with delays or conditions that can cause delays. If your child has developmental concerns, ask your pediatrician about an evaluation.
Keep copies of evaluations and therapy notes in the same folder as the prenatal and delivery records.
If your child is older than three, ask about school-based services and an Individualized Education Program (IEP).
What to say (and not say) to insurers
- Do keep statements brief and factual.
- Do not guess about timing or cause.
- Do not sign broad releases before you understand what they cover.
- Do say you are gathering records and will respond after review.
If an insurer asks for a recorded statement, it is reasonable to request time to review records first.
If you are unsure who is calling, ask for the company name and a callback number so you can verify it.
Practical next steps for families
Organize records: Keep prenatal, delivery, and newborn records in separate sections. Label items by date.
Ask clear questions: Which risks were identified and when? What follow-up was recommended? Were referrals completed?
Track symptoms: Keep a log of symptoms you reported and the guidance you received.
Plan follow-up visits: Confirm postpartum visits and any specialist appointments.
Request a summary letter: Ask your OB for a concise summary of the pregnancy and delivery. It helps with future care planning.
Save portal messages: Keep copies of any written advice or test results shared through patient portals.
Claim timeline: what to expect
Month 1-2: Record requests and initial review of prenatal testing.
Months 3-6: Specialist review of records and clearer understanding of risk management.
Months 6-12: Ongoing care planning and any needed therapy for the child.
Longer cases: Some cases require extended review and expert input before conclusions are reached.
Ongoing: Future pregnancy planning often includes earlier monitoring and additional testing.
As needed: Additional consultations or imaging may be recommended if new concerns arise.
Long-term: Some families continue to update care plans as new pediatric needs appear.
Review annually: Ask your OB or pediatrician if there are any updated recommendations based on new guidelines or your child’s progress.
FAQ
Does a missed prenatal diagnosis always mean malpractice?
No. Some conditions develop quickly or are hard to detect. The medical record is needed to understand whether care was appropriate.
What if I missed appointments?
Missed appointments can affect monitoring, but providers should still document risks and offer follow-up. The record will show what was recommended.
How soon should we request records?
As soon as possible. Early access helps you understand the timeline and organize next steps.
When to talk to a lawyer
If you have concerns about missed warning signs, delayed testing, or lack of follow-up, a lawyer can help obtain records and connect you with medical experts for review. Early review helps preserve evidence and clarify options.
Disclaimer: This article provides general information, not legal advice. Every case is different, and you should consult a qualified attorney about your specific situation.