Birth injuries, usually defined as an impairment of the newborn’s body functions or structure because of an adverse event that occurred during the birth process, can happen during labor, delivery, or right after delivery. While healthcare providers know and can address most of the risk factors associated with birth injuries, there are still many types of birth injuries occurring in U.S. hospitals.
Causes of Birth Injuries
Birth injuries can be caused by numerous issues, including pre-existing conditions in the mother, premature separation of the placenta and the uterine wall, the size or position of the baby during labor and delivery, prolonged or difficult labor, and mistakes or negligence on the part of doctors, nurses, or other healthcare providers that leads to lack of oxygen or trauma and injury to the baby.
Common Birth Injuries
Bruising or swelling are a very common type of birth injury that results from traveling through the birth canal. These bruises on the face or head and swelling of the scalp will generally go away within a few days. Pressure on a baby’s face during labor or delivery may also damage his facial nerve so that one side of his face will not be able to move. If the nerve was only bruised, movement will occur within a few weeks; if the nerve was torn, surgery will be needed to repair it.
Brachial palsy is similar in that if the brachial plexus (the network of nerves that control the arms and hands) is damaged during labor or delivery, the baby will not be able to move his arm for a few months until the bruising and inflammation around the nerves heal. If, however, the nerve was actually torn, the nerve damage could be permanent.
Fractures of the collarbone are the most common type of fracture during labor and delivery because the bone is susceptible to breaking during a difficult delivery. Usually the injury will heal quickly, as new bone will form and grown.
Serious Birth Injuries
Serious birth injuries affecting the spinal cord or major organs can cause long-term conditions and disabilities. Leading among these are brain injuries that often develop due to oxygen deprivation. Deprived of oxygen, an infant may develop brain ischemia where the brain reacts to oxygen deprivation by draining the blood from the brain. In contrast, excessive blood coming to the brain can cause a hemorrhage, and additional electrical signals can cause general brain damage or severe electrical disorders with cerebral palsy.
The most common brain-related birth injury is cerebral palsy, which can develop due to oxygen deprivation, maternal infections, infant infection, and infant stroke. Often, cerebral palsy could have been avoided had the physician taken the appropriate preventative actions, such as treating maternal infections, monitoring and addressing instances of fetal distress, seeing and treating a prolapsed umbilical cord, and using birth-assisting tools properly.
Brachial plexus injuries can also be very serious if the nerve was torn during labor or delivery. Nerve damage affecting the arm, and possibly the shoulder and hand, can be permanent. With Erb’s Palsy, the nerves of the upper arm are affected, sometimes resulting in total paralysis of the affected arm. With Klumpke’s Palsy, damage to the nerves in the lower arm affects the ability to move the arm, hand and fingers. Usually the hand permanently takes on a claw shape.
Shoulder dystocia, an injury that occurs during delivery when the infant’s head and shoulders get caught behind the mother’s pelvic bone, is not as common as brachial plexus injuries, but the complications can be very serious. The baby may have problems breathing, a fractured collarbone, cerebral palsy, or she could even die.
Injuries During Delivery
In addition to shoulder dystocia, other types of injuries can occur during delivery from the improper use of a vacuum extractor or forceps, from administering the wrong medication, and improper handling of the infant.