There are many different factors that may contribute to the occurrence of birth injuries. Even when pregnancies have been completely without incident, it is possible for complications to arise during labor that cause birth injuries. Many birth injuries are the result of natural complications, but some may also be caused by medical negligence.
Natural Birth Injury Causes
While natural complications can cause birth injuries, competent physicians may be able to take action to correct complications before injuries occur. If a birth injury was caused by natural complications, it may still show negligence on the part of the attending physician if it can be proven that the physician did not perform the actions that would be expected from an equally competent physician in the same situation. Physicians owe patients a duty of care and may be liable if it is determined that the physician did not meet the standard of care that is expected. Complications that physicians are trained to anticipate may include umbilical cord prolapse, abnormal positioning, umbilical cord compression, and prolonged labor.
Prolonged labor is a common complication that may cause birth injuries. Prolonged labor is also referred to as “failure to progress.” Labor is generally considered prolonged if contractions have been occurring regularly for 20 or more hours. If the mother is carrying twins or more, labor is considered to be prolonged after about 16 hours of contractions. New mothers are more prone to prolonged labor than mothers that have given birth previously. Prolonged labor can put both the mother and child at risk for infection and can cause oxygen deprivation or abnormal heart rhythm if not addressed in time.
Prolonged labor may be caused by several factors, including:
- Infant too large to move through birth canal
- Unusually small or constricted birth canal
- Abnormally weak contractions
Umbilical Cord Prolapse or Compression
The umbilical cord is the baby’s life line up until the moment of birth. If the umbilical cord slips through the birth canal before the baby or becomes compressed, it can stop the flow of oxygen and nutrients that the baby needs to survive. The deprivation of oxygen and blood flow can cause serious damage to the infant’s brain and body and may even cause death if not caught quickly enough.
Babies usually come out of the womb head first and facing the mother’s back, with faces tucked to the chest. This position allows the largest part of the baby, the head, to come through the birth canal and the cervix first and leaves less chance that any part of the baby’s body will become hung up. The back and top of the head is also presented first through the birth canal, putting less pressure on the face and neck. In “back labor” the baby is born facing the mother’s abdomen, which may tear the birth canal and make labor prolonged and more painful. If the head is positioned wrong, the baby’s face or forehead may come through the birth canal instead of the back of the head, which can cause injuries to the face and neck. If the baby is born with the buttocks of feet pointed down, it is called a breech birth and may cause the baby’s head to get hung up in the birth canal.
Negligence Based Birth Injuries
Most negligence-based birth injuries occur when doctors attempt to take action to correct complications. Physicians may engage in improper delivery techniques and impose too much pressure or force on the baby by trying to pull to speed the labor process. Physicians may also fail to order an emergency cesarean section in time after a vaginal birth has become complicated enough to threaten the health of the baby and the mother.
Improper Use of Tools
Physicians may employ forceps or a vacuum extractor to assist with labor. If used improperly, these tools can injure the child’s head or body. In some cases, injuries such as lacerations may damage nerves or become infected. Improper use of tools may also cause the baby to change positioning when coming through the birth canal, which may result in extreme complications such as shoulder dystocia.
“Birth Injury.” Stanford Children’s Health. Stanford Children’s Health, 1 Jan. 2014. Web. 20 Jan. 2015. <http://www.stanfordchildrens.org/en/topic/default?id=birth-injury-90-P02340>
“Birth Injury.” University of Rochester Medical Center. University of Rochester Medical Center, 19 Jan. 2015. Web. 20 Jan. 2015. <http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02340>
“Labor & Delivery Causes.” BirthInjury.org. Brockton Creative Group, 1 Jan. 2010. Web. 20 Jan. 2015. <http://www.birthinjury.org/brain-injury-cerebral-palsy-labor-delivery-causes.html>