From 1995 to 1998, researchers at the Urban Institute documented trends in the medical malpractice environment and demonstrated how the malpractice environment affects defensive medicine in obstetrics practice.
Researchers classify low-value tests and procedures, performed more for legal than medical reasons, as "positive" defensive medicine. Avoidance of high-risk patients or procedures is considered to be "negative" defensive medicine.
Project researchers focused on the question of whether higher malpractice risk leads to more Cesarean sections (positive defensive medicine) or to diminished access to obstetric care for high-risk patients (negative defensive medicine).
They examined the effect of liability concerns on Cesarean section rates, analyzed the effects of liability on access to obstetrical care, and conducted a case study of how liability concerns affect the practice of obstetrics in managed care.