Birth injuries can vary in severity and impact, ranging from mild, temporary conditions to severe, permanent disabilities.
What are some of the most common birth injuries?
- Cerebral Palsy: This is a permanent movement disorder that develops during infancy or early childhood. As explained by the Mayo Clinic, while medical professionals are not sure about what exactly causes this disorder to develop, the likely suspect is damage that occurs to the child’s brain before, during, or after birth. It may affect muscle tone, movement, and motor skills.
- Brachial Plexus Injuries (Erb’s Palsy and Klumpke’s Palsy): As discussed by John’s Hopkins Hospital, these forms of palsy typically involve damage to the brachial plexus, the nerves that facilitate communication between the spine through the shoulder, arm, and hand. Erb’s Palsy affects the upper brachial plexus, leading to weakness or paralysis of the shoulder or arm. Klumpke’s Palsy affects the lower part, potentially leading to the inability to freely move or feel the wrist and hand.
- Perinatal Asphyxia: This condition occurs when the baby does not receive enough oxygen before, during, or immediately after birth, leading to potential brain damage and other organ dysfunction.
- Intracranial Hemorrhage: Refers to bleeding inside the brain or skull, which can occur during a difficult delivery. Types include subarachnoid hemorrhage, intraventricular hemorrhage, and subdural hemorrhage, each depending on the location of the bleeding within the brain or skull.
- Cephalohematoma: This is a collection of blood between a baby’s scalp and the skull bone that typically results from birth trauma. It usually resolves independently but can lead to jaundice if the blood breaks down and increases bilirubin levels.
- Caput Succedaneum: Swelling of the soft tissues of the baby’s scalp arises as the baby moves through the birth canal. It’s generally harmless and resolves within a few days after birth.
- Bone Fractures: The clavicle (collarbone) is the most common bone to fracture during birth, especially under challenging deliveries or from using delivery instruments. Fractures typically heal well with minimal intervention.
- Facial Paralysis: Pressure on the baby’s face during delivery or the use of forceps can damage the child’s delicate nerves and lead to temporary or permanent facial paralysis. In many cases, the paralysis resolves independently as the nerve heals. In other cases, the baby may need to undergo surgery to treat the damaged nerve.
- Hypoxic-Ischemic Encephalopathy (HIE): This form of brain damage is caused by a reduction in oxygen and blood flowing to the baby’s brain around the time of birth. HIE can lead to developmental delays, cerebral palsy, and other permanent disabilities.
These injuries can result from a variety of factors, including the baby’s size and position during birth, the length of labor, and medical interventions used during delivery. Often, managing the effects of these injuries and improving outcomes for affected infants begins with early diagnosis and treatment.
What Causes Birth Injuries During Labor and Delivery?
Injuries during the birthing and delivery process can occur due to a variety of factors. These factors may involve complications during the birthing process, medical interventions, or underlying health issues in the mother or baby. Understanding these causes can help you and medical professionals anticipate potential risks and manage labor and delivery more safely. Here are some common causes of birth injuries:
Prolonged Labor or Difficult Delivery: Extended labor, especially in the second stage, can put excessive stress on the baby, leading to potential injuries. Difficult deliveries, including those where the baby is in an unfavorable position (e.g., breech presentation), can increase the risk of injury.
Premature Birth: Babies who are premature have a higher risk of birth injuries because their bodies are less developed and more fragile compared to full-term babies.
Large Baby Size (Macrosomia): Babies with a birth weight over 8 pounds, 13 ounces (4000 grams) are considered more significant than average. Macrosomia can make vaginal delivery more challenging and increase the risk of shoulder dystocia and brachial plexus injuries.
Use of Assistive Delivery Devices: Instruments like forceps or vacuum extractors, used to assist or expedite delivery, can increase the risk of physical injury to the baby’s head, neck, spine, or shoulders if not used carefully.
Cephalopelvic Disproportion (CPD): CPD occurs when the baby’s head or body is too big to travel through the mother’s pelvis. This mismatch can lead to complications and injuries during vaginal delivery.
Oxygen Deprivation (Hypoxia): This can occur if the umbilical cord becomes compressed or twisted during labor or due to placental abruption or insufficiency. Hypoxia can lead to brain injuries such as cerebral palsy or hypoxic-ischemic encephalopathy (HIE).
Medical Negligence: Errors or delays in responding to complications, improper use of delivery tools, or failure to perform a necessary cesarean section (C-section) promptly can result in birth injuries.
Maternal Health Issues: Conditions in the mother, such as infections, diabetes, high blood pressure, or obesity, can lead to complications during labor and the process of giving birth and may lead to injuries.
Intrauterine Infections: Infections within the uterus, such as those that cause inflammation or infection of the amniotic fluid (chorioamnionitis), can lead to complications affecting the baby.
Mechanical Stress on the Body During Birth: The physical pressure and stress of passing through the birth canal can lead to bruising, nerve damage, or fractures, especially in a difficult or assisted vaginal delivery.
Many birth injuries are preventable with proper prenatal care, careful monitoring during labor and delivery, and timely medical intervention when necessary. Healthcare providers aim to balance the benefits and risks of different delivery methods and interventions to minimize the risk of birth injuries while ensuring the safety of both the mother and the baby. However, they can make mistakes that damage the unborn or newly born infant.
How Can Birth Injuries Be Prevented?
Preventing birth injuries involves a combination of careful prenatal care, monitoring during labor and delivery, and appropriate medical intervention when necessary. Here are key strategies that healthcare providers and expectant mothers can consider to minimize the risk of birth injuries:
Comprehensive Prenatal Care: Regular prenatal visits allow the medical team to keep track of the health of the mother and the fetus, manage chronic conditions (e.g., diabetes, hypertension), and identify risk factors. (e.g., fetal position and size). These risk factors may lead to complications during delivery, so it’s best to catch and address these sooner rather than later.
Risk Assessment: Early identification of potential risk factors, such as maternal health issues, fetal size, and presentation, can help in planning for a safer delivery. For example, a scheduled cesarean section (C-section) might be considered for breech presentations or in cases of cephalopelvic disproportion (CPD).
Monitoring During Labor and Delivery: Continuous monitoring of the fetus’s heart rate and the mother’s labor progress can help detect signs of distress or complications early. Prompt intervention can then be taken to prevent injury.
Appropriate Use of Delivery Techniques: When interventions are necessary, such as vacuum extractors or forceps, physicians must ensure correct use and only act when medically indicated to reduce the risk of injury.
Timely Decision for Cesarean Section: In cases where labor is not progressing or if there is fetal distress, a timely decision to proceed with a C-section can prevent potential injuries associated with prolonged labor or difficult vaginal deliveries.
Skilled Delivery Team: A qualified and experienced delivery team can significantly reduce the risk of birth injuries. A professional team may include obstetricians, midwives, pediatricians, and anesthesiologists who can respond effectively to a range of complications.
Education and Birth Planning: Educating expectant parents about the signs of labor, when to come to the hospital, and what to expect during delivery can help prepare them for a smooth delivery process. Birth planning discussions, including preferences and potential interventions, can set realistic expectations and reduce anxiety.
Avoiding Unnecessary Interventions: Interventions such as labor induction and the use of epidural anesthesia should be used sparingly, as they can sometimes lead to complications or prolonged labor, increasing the risk of birth injuries.
Fetal Positioning Techniques: Techniques such as external cephalic version (ECV) for breech presentations encourage the fetus into a safer position for vaginal birth, reducing the need for a C-section or the risk of birth injuries.
Postnatal Care and Monitoring: After delivery, careful newborn monitoring for signs of distress or injury allows for early intervention and treatment, which can mitigate long-term effects.
Doctors cannot prevent all birth injuries, but these strategies can significantly reduce their incidence and severity. Collaboration between healthcare providers and expectant mothers, along with timely and appropriate medical interventions, is critical to ensuring the safest possible outcome for both the mother and the baby. At all times, however, the medical team should make sure to follow generally accepted standards of medicine to help mitigate the chance of avoidable harm to the baby.
If you or a loved one were a victim of a birth injury due to negligence, you should contact Baltimore Birth Injury Attorneys of the Snyder Law Group. Our firm has a long and storied history of litigating birth injuries, including settlements of up to eight million dollars.