A birth injury or birth-related injury is any physical harm caused to the mother or baby immediately before, during, or shortly after childbirth. We recently discussed birth injuries in relation to the mother here. In this article, we will consider birth injuries to the baby.
A birth injury is different than a birth defect. Birth defects are conditions or abnormalities that develop during pregnancy, usually as a result of a genetic abnormality or health condition. Although some birth defects could be avoided or minimized by prenatal care and screening, birth defects are typically not the result of medical malpractice. A birth injury, which happens immediately before, during, or shortly after, the delivery of the baby, usually occurs because something has gone wrong during the delivery.
If your child suffered a birth injury, you may be wondering what went wrong and what you can do now. Our birth injury attorneys at Morris James help parents of injured infants get answers to these questions and compensation for your child’s injury. We know that no amount of money can compensate you or your child for the suffering and loss that you and your child have endured, but it may help you to clear the mounting medical bills and to pay for the extra care that your child needs in the future as a result of their birth injury.
What injuries can occur at birth and how do they happen?
Sadly, there are many different ways that a child can be injured during the birthing process or at birth. Birth injuries can range from minor injuries that resolve quickly, to severe, and even fatal, harm. Some of the injuries that can occur during childbirth are:
A fractured or broken bone can happen as a result of the force or positioning used to get the baby out of the birth canal. The clavicle, or collar bone, is the most common bone fractured during childbirth, occurring in up to 15 of every 1000 live births. Skull fractures are also reported, most commonly as a result of instruments, such as forceps, used during delivery, sometimes resulting in intracranial injury or neurologic damage to the baby. Suspected fractures require the intervention of a specialist in order to prevent lasting damage and mobility issues.
In some fracture situations, the amount and type of force used is medically appropriate to deliver the baby. In other cases, however, the actions taken by the medical professionals were inappropriate, and the fracture could have been avoided.
In difficult deliveries, an infant’s nerves can get overstretched or torn, which can lead to temporary or lasting damage. There are many different types of nerve damage. Some of the more common are:
- Facial Paralysis: Facial nerves can be damaged by the use of forceps or other delivery tools and methods. When the facial nerves are damaged, that can affect the movement and appearance of one side of the baby’s face. In most cases, facial paralysis is temporary and will resolve on its own in a matter of weeks or months. For some children, unfortunately, there is lasting damage.
- Brachial Plexus Injury or Palsy / Erb’s Palsy: Brachial plexus injury or palsy refers to paralysis or loss of movement in the arm or shoulder area caused by damage to the brachial plexus (nerves in the neck area). Erb's Palsy is the most common type of brachial plexus injury or palsy. Damage to the brachial plexus is usually due to the force used by the clinician to deliver a baby. This often occurs when the baby’s shoulder is stuck on the mother’s pubic bone during delivery (a condition called shoulder dystocia). When there is shoulder dystocia, the baby does not descend the birth canal, requiring various interventions to deliver the child safely and quickly to avoid permanent injuries. Brachial plexus injury or palsy is usually temporary, but if it does not resolve, it can leave a child with permanent loss of movement in parts of the arm, shoulder, and, in some cases, fingers.
Brain injuries can be caused in a number of ways during labor and delivery, including oxygen deprivation, loss of blood flow, bleeding in the brain, and trauma/force. Thankfully, these are rare. But, when there is a brain injury related to birth, the most common types include:
- Cerebral Palsy: Cerebral palsy is a severe motor disability caused by abnormal brain development. While cerebral palsy is sometimes to linked to genetic conditions and developmental problems, It can also be caused by infections left untreated during pregnancy or after delivery (such as rubella or severe jaundice,) physical injury to the skull during delivery (sometimes by forceps,) lack of oxygen to the baby’s brain during labor, or failure to carry out a C-section when medically indicated. Cerebral palsy can have a major effect on a child’s life, requiring complex and expensive treatment and care.
- Hypoxic ischemic encephalopathy (HIE): HIE is caused by lack of blood and oxygen to the infant’s brain. A severe brain injury can cause permanent physical and mental delays and disabilities. There is no cure for HIE, but the effects of it can be reduced, in some situations, where therapeutic hypothermia is indicated and is administered to the baby in the hours immediately after birth. HIE unfortunately can be caused by medical malpractice during delivery. There are many causes of HIE, including prolonged labor, failure to carry out an emergency C-section, umbilical cord difficulties, placental or uterine issues, failure to monitor the baby during and immediately after delivery properly, and failure to diagnose and treat HIE promptly. Many of these causes are preventable, but occur in the presence of medical malpractice.
- Brain bleed / Hemorrhage / Hematoma: A hemorrhage (bleeding) or a hematoma (pooling of the blood) can lead to conditions from mild swelling to permanent brain damage to an injured infant. Brain bleeds can be caused, or made worse, by the action or inaction of the medical team at birth. Newborn babies must be monitored for swelling, apnea (breathing pauses), seizures, poor feeding, and bluish coloring around the mouth and nail beds, which can all indicate brain bleeds, and may require specialist intervention.
Babies can suffer lacerations from surgical tools used in a cesarean section, or by tools used during a vaginal delivery. The most common lacerations occur in the baby’s face, ears, and head. A laceration can damage nerves, leave scarring, and lead to infection. Many of these injuries are preventable if mistakes were not made by the medical team during delivery.
Infection during pregnancy can cause birth injuries when it is not recognized or treated appropriately and in a timely manner. Common infections are:
- Group B streptococcus: Group B strep is a common bacteria in women but is very dangerous to a newborn baby. If Group B strep is detected, it can be easily treated, but if left untreated, it can cause serious neurologic damage to an infant.
- Toxoplasmosis: Toxoplasmosis is a parasitic infection sometimes contracted from cat feces, potting soil, or raw meat. If an expectant mother transfers a toxoplasmosis infection to her baby, it may affect the baby’s development and lead to brain damage, hearing loss, or vision problems.
- Infections from birth injuries: An infant with a laceration, oxygen deprivation, or other birth complications is susceptible to other infections. Newborn babies, especially premature babies, have underdeveloped and developing physiological systems, and are at high risk of complications and infections. Babies who require medical interventions due to a birth injury, such as a feeding tube or surgical procedures, are also at greater risk of infection.
How do I know if my child has suffered a birth injury?
Knowing your child has suffered a birth injury can be challenging. Some injuries, even serious issues, are not obvious until the child is older and failing to meet developmental milestones. Some symptoms to look out for in your child after birth are:
- Bruises, scratches, or lacerations
- Swelling, particularly on the baby’s head
- Low Apgar scores
- Apnea (pauses in breathing)
- Bluish coloring around lips or nail bed
- Difficulty nursing/feeding
- Hand curled into a claw-like shape
- Muscles limpness or stiffness
- Excessive crying or fussiness
- Limp appearance on one side
- Abnormal vital signs, blood work, or imaging studies
Your medical team in the hospital, and your pediatrician after discharge from the hospital, should carry out newborn screening and monitoring to detect potential issues. Some conditions can be minimized or treated if detected early. If you are concerned about these or any other symptoms in your child, contact your pediatrician as soon as possible.
Are birth injuries always the result of medical malpractice?
Birth injuries are not always caused by medical malpractice. Some births are particularly difficult and can lead to complications that cannot be avoided, even with proper medical care. Some factors, such as breech presentation of the baby, a large baby, a small mother, a baby that is stuck above the mother’s pubic bone, or genetic conditions of the mother or baby, can make a birth high risk in and of themselves. However, advances in modern medicine have made all of these conditions more manageable and have led to a substantial reduction in birth injuries. As a result, often, a clinician can minimize the risk of a birth injury so long as the standard of care is followed. In situations where a healthcare provider acts inappropriately, however, especially when a mother or her baby has risk factors, the chances of the baby’s injury being caused by medical malpractice are much higher.
Any situation in which an infant is injured at birth should always be fully investigated and explained. If your doctor, midwife, hospital, or birthing center is reluctant to investigate the circumstances of your child’s injury or unwilling to answer your questions, you may need help getting answers. An experienced birth injury attorney, like the birth injury lawyers at Morris James, knows how to help get you the answers you deserve.
If you want to talk to someone about your child’s injuries, the attorneys at Morris James are ready to listen to you. We will talk to the hospital and insurance companies on your behalf, and use our experience and legal tools to access the information you have not been able to get on your own. Contact us today for a no-obligation consultation.