Causes of Birth Injury
Birth injury or trauma is caused quite naturally in the birthing process. After all, the baby is being squeezed through the mother’s pelvis, and during contractions, the baby’s oxygen supply is temporarily stopped. Each phase of labor involves compression, twisting, and tensing of the body, and even infants delivered by Cesarean section must first endure the stress of a long labor.
Children born with minor birth injuries typically recover on their own, without treatment. However, serious birth injuries can be life-threatening or cause long-term disabilities and impairment.
There are two main reasons why babies are injured during birth:
- Oxygen deprivation. It can take as little as six minutes for a child to suffer brain death. When the baby is stuck inside the birth canal for too long or has a blockage of umbilical blood flow, its oxygen reserves run out. A lack of oxygen and buildup of carbon dioxide in the blood, tissues, and organs is serious. Cerebral palsy, “perinatal asphyxia” or hypoxic-ischemic encephalopathy, and other types of lifelong brain damage are all caused by oxygen deprivation.
- Physical trauma. Cuts, bruises, bleeding, swelling, burst blood vessels, broken bones, damaged nerves, and paralysis are all types of mechanical damage the baby might suffer on the way out. Usually, these injuries are considered “minor” and heal by themselves, but some types of nerve damage—like a severe brachial plexus injury—do not heal at all.
The good news is that medical imaging and technology nowadays is much better than it was even a few years ago. The bad news? Preventable birth injuries still happen in as many as 30% of deliveries.
Fetal Risk Factors
Childbirth is a risky proposition for both the mother and the baby. When severe birth injuries occur, it’s usually a combination of risk factors and improper or slow medical intervention by the doctor. Here are factors loosely associated with the fetus that can cause greater risk of injury:
- Prematurity: Babies born before 37 weeks have a higher risk of birth injuries. They are more fragile and have fewer natural defenses.
- Large baby (macrosomia): If the baby is too large to travel through the mother’s pelvis, there’s a greater risk of injury, specifically through shoulder dystocia.
- Abnormal delivery positions: Physicians should be able to determine what position a child will be born in a week before delivery. If the baby is breech or in face-first presentation, complications could be prevented with a C-section delivery.
- Umbilical cord complications: Problems in the umbilical cord can cause the baby to develop too slowly inside the womb, be deprived of oxygen and nutrients, and suffer fetal distress.
- Placental complications: When the placenta is compromised, both mother and baby are in danger. The placenta can detach too early, cutting off the baby’s blood and oxygen supply, or it can cause excessive bleeding and infection in the mother.
- Shoulder dystocia: The most dangerous situation in labor. When the baby’s head comes out of the birth canal but his shoulders are stuck on mom’s pelvis, that’s a type of “dystocia” or difficult birth that needs to be resolved quickly. Since the baby is already partly out, a C-section can’t be performed. Dystocia is sometimes associated with the mother’s birthing position.
Maternal Risk Factors
- Cephalopelvic disproportion: If the mother’s pelvis is not shaped to accommodate vaginal birth, or if the child is too large, it can lead to abnormally long labor or shoulder dystocia; compression can cause injury to the baby’s brain.
- Obesity: If the mother is overweight, she is at risk for gestational diabetes and preeclampsia, which can cause fetal distress. Around 36% of Americans are obese (having a BMI of 30 or greater).
- Infections: Some viral or bacterial infections can be transmitted from mother to baby while the baby is still in utero. Others can be transmitted during the birthing process if proper precautions are not taken by medical professionals: cytomegalovirus, toxoplasmosis, parvovirus, syphilis, listeriosis, hepatitis, HIV, or Group B streptococcus. Testing needs to be done during pregnancy, a many of these can be treated with antibiotics, vaccines, or C-section delivery to reduce the baby’s exposure.
- Uterine problems: Weak contractions, too-strong contractions, or a previous C-section scar causing uterine rupture can harm the baby. Giving labor-inducing medication to the mother can increase the risk of uterine problems.
- Delayed birth/prolonged labor: Delayed birth is a leading cause of birth injuries. Pressure on the child’s brain may become too much to withstand when the baby remains in the birth canal for more than 18 hours of labor. Many medical professionals believe that a labor lasting more than 18 hours requires an emergency C-section.
Medical Causes of Birth Injury
Medical errors do occur, even in the U.S.
Physicians, nurses, midwives, hospital staffs, and EMTs, although they are trained, make mistakes that cause injury to newborns. Common medical errors that can lead to birth injury or trauma include:
- Not monitoring the baby closely for signs of distress.
- Improper use of forceps.
- Improper use of vacuum extractor.
- Excessive pulling or “traction” on the baby.
- Giving medications to the mother shortly before or during delivery that put the child at risk.
- Miscommunications or misunderstandings between medical staff.
- Failing to perform an emergency C-section when needed.
Some birth injuries would not exist if medical providers didn’t make mistakes. Brachial plexus injuries, including Erb’s palsy and Klumpke’s palsy, are almost always caused by doctors or medical staff pulling or twisting the baby’s head and neck while trying to deliver it.
More About Birth Injury Safety
Medical professionals are trained to do everything possible to keep a mother and child safe during labor and delivery. When they fail in their duty and cause birth injuries to your child, you have every right to take legal action. Compassionate birth injury attorney Laura Brown is here to help. Call (214) 974-4121 for a free case consultation.
- Merck Manual: Birth Injury
- Stanford Children’s Health: Birth Injury
- American Family Physician: Shoulder Dystocia
- Johns Hopkins Medicine: Brachial Plexus Injury
- National Institutes of Health: Brachial Plexus Injury