Types of Birth Injuries
Medical accidents are unfortunate, but they often occur. Perhaps the worst among them happens during child delivery. Birth injury includes any harm to a baby during, shortly after, or even before the delivery. Birth injuries affect 7 in 1000 newborns and, in many cases, are largely preventable.
While many babies suffer minor injuries that heal without treatment, some cases are more severe and require prompt and proper medical attention. Otherwise, they may lead to permanent disabilities that affect the child emotionally, cognitively, or physically.
Unfortunately, some birth injuries are not treatable, and a child may have to live with a disability for their entire life. But in many cases, a physician can prevent the problem by adhering to standards of care, closely monitoring the health of the mother and child, and addressing any suspicious issues that may develop during pregnancy, labor, and delivery.
Although the causes are still not well understood, cerebral palsy (CP) often results from brain injury before, during, or after child delivery. It can affect muscle control and lead to speech and developmental delays. This condition can occur in up to 4 in 1000 live births and can have lasting effects on functioning.
The cause of the brain injury may occur due to:
Heart attack or stroke
Bleeding in the brain
Fever and infection
Oxygen deficiency in the brain
This condition has no known cure at the moment, but many treatments are available to help relieve the symptoms and help patients live more independently.
Brachial plexus or Erb’s palsy is a birth injury resulting from paralysis of the child’s shoulder, arm, or hand. This type of birth injury results from severe or mild damage to those nerves during delivery. The brachial plexus nerves help control feeling and movement and connect the spinal cord to the arms.
The nerve damage can occur as a result of:
- Excess pulling on the baby’s head or neck
- Stretching the child’s feet in a breech (feet first) delivery
- Stuck shoulders, head, or neck under the pelvic bone or in the birth canal during delivery
A child with Erb’s palsy can recover without any treatment. Some children require surgery, occupation, or physical therapy to recover fully and severe cases may cause permanent damage or paralysis to the affected limb.
The spine transmits signals to the brain, allowing it to control the body’s limbs. Spinal damage can interfere with these signals and affect a child’s movement and sense of touch. The injury often occurs when a doctor pulls the child’s spine too hard during birth. While spine damage was once thought to be irreparable, recent research has suggested that surgery is an option and has resulted in “significant neurological recovery.” If surgery is not available or recommended, treatment and physical therapy can prevent the injury from becoming worse.
Kernicterus / Jaundice
Jaundice occurs due to high levels of bilirubin, a pigment created when your body replaces blood cells. Although jaundice often clears up within fourteen days, too much bilirubin content may continue to accumulate and result in permanent brain damage. Untreated jaundice can cause kernicterus, a condition when the bilirubin begins to collect in the child’s brain.
Yellow skin or eyes
Loud, high-pitched cry
Later, kernicterus may cause various health issues such as seizures, brain damage, and hearing loss.
Hypoxic Ischemic Encephalopathy (HIE)
A child may suffer from Hypoxic Ischemic Encephalopathy (HIE) if they lack oxygen and blood flow during delivery. That could be due to:
- Abnormally long labor
- Placental bleeding or abruption (a pregnancy complication in which the placenta detaches from the uterus)
- Fetus in the wrong position (the most common and safest position is head down, facing the mother’s back, with the chin tucked toward the chest)
- Umbilical cord prolapse (where the umbilical cord passes through the cervix before the baby does, which causes it to be squeezed during the process of birth)
Hearing and vision problems
HIE affects the baby more if the injury is severe. However, some children do not experience any long-term health issues at all.
- Anemia due to blood loss
- Depressions or swelling in the head
- Larger than average head size
Intrauterine Fetal Demise
This type of child-birth injury, also known as stillbirth, occurs when the fetus dies before delivery.
Factors increasing the risk of intrauterine fetal demise include:
- Umbilical cord prolapse is a rare birth complication that occurs when the umbilical cord drops via the open cervix into the vagina before the child moves into the birth canal
- Genetic factors
- Carrying twins, triplets, or other multiples
- Maternal diabetes, obesity, and high blood pressure
What are the leading causes of birth injuries?
Birth injuries can occur due to the child’s size or position during labor and delivery. Other reasons include:
- Birthweight of more than 9 pounds
- Preterm birth (before 37 weeks gestation)
- Cephalopelvic disproportion
- Difficult labor or delivery
- Prolonged labor
- Breech delivery
- Maternal obesity
During delivery, birth asphyxia (oxygen deprivation) may lead to brain damage (known as hypoxic-ischemic encephalopathy). The brain is the most vulnerable to a lack of oxygen, but more severe oxygen deprivation can also affect other organs. Luckily, proper medical management can prevent brain damage. In addition, administering therapeutic hypothermia (via cooling blankets or other treatments) after the initial injury may minimize permanent damage.
Causes of oxygen deprivation
- Umbilical cord issues such as short cord and cord prolapse
- Uterine rupture
- Placental abruption (when the placenta separates from the uterus prematurely)
Forces such as pressure and torsion on the baby can cause traumatic birth injuries. These injuries may further lead to cerebral palsy or brain damage due to oxygen deprivation. However, many traumas are preventable if the doctor closely monitors the mother and the child during pregnancy and delivery.
A child comes into contact with the mother’s birth canal during labor and vaginal delivery, exposing them to bacteria and viruses. Unfortunately, some of the strains are harmful. That is why medical professionals need to run tests for specific maternal infections during prenatal care.
Failure to identify and treat the infections early on can lead to encephalitis when they travel to the brain, meningitis when they reach the spinal cord and membranes, or pneumonia when they infect the lungs.
Other than infections, various maternal health conditions can increase the risk of birth injuries. Examples include:
- Post-term pregnancy
- High blood pressure
- Premature rupture of membranes
- Carrying multiples (twins, triplets, or more)
- Advanced maternal age (over 35)
- Other health conditions such as kidney disease, autoimmune disorders, or thyroid issues
Prenatal care visits are critical for high-risk pregnancies for the doctor to see how the mother and baby are progressing.
Birth injury treatment varies depending on the baby’s specific needs. Some children may need less treatment in their entire life while others require long-term medical intervention. Some treatment options for birth injuries are:
It helps children who have difficulties accomplishing daily tasks such as reading, writing, bathing, eating, and brushing their teeth. Those with developmental delays in speech can undergo speech therapy.
A child who finds it difficult to move can use assistive devices such as wheelchairs, leg braces, or crutches. Others may need catheters or breathing support if their injuries are more severe.
Medications can help treat pain and seizures, spasticity, swelling, and incontinence.
Surgery is an option in situations where medication, therapy, and assistive devices won’t help. For instance, brain bleeds, seizures, and blood clots may need surgery.
Other types of birth injuries require special treatment. For example, infant hematomas may require burr hole surgery, while newborn jaundice requires light therapy.
Seeking Proper Medical Diagnosis and Legal Support
Some birth injuries are detectable immediately after birth, while others will take months or years after the delivery before diagnosis. Doctors and parents realize when the child fails to meet significant developmental milestones. Nevertheless, the diagnosis of the affected body parts involves a series of tests to determine effective treatments, regardless of the time you discover the injury.
The tests include:
- Apgar score: An Apgar test is conducted immediately after birth and examines the child’s muscle tone, breath, heart rate, skin tone, and reflexes. A higher score is associated with better health, while a lower score shows that the newborn is in distress.
- Brain imaging: Medical professionals can use CT, MRI, or other imaging tests to examine the brain for HIE or cerebral palsy.
- Umbilical cord blood gas analysis: An umbilical cord blood gas analysis can help determine whether a child suffered from HIE or other health conditions during birth.
A birth injury prognosis is an outcome one should expect after the injury.
If your infant suffers from a birth injury resulting from malpractice or negligence, you could be eligible for compensation to help cover the treatment costs and other expenses. The medical professional who caused your baby’s birth injury is accountable for any damage caused. Seek legal advice to know whether you are entitled to compensation to cover treatment costs.
Birth Injury Center Team
The Birth Injury Center aims to create informational web content and guides to help women and their families seeking support and guidance for birth injuries caused by medical negligence. All of the content published across The Birth Injury Center website has been thoroughly investigated and approved by medical expert Natalie Speer, RNC-OB, Attorney Ryan Mahoney, and Attorney Rick Meadows.