Traumatic birth injuries - How complications at birth can cause trauma to your newborn
Traumatic birth injuries are injuries caused during the birth process and range from minor scratches and bruises to paralysis or even stillbirth.
Giving birth is supposed to be one of the most treasured moments of a woman’s life. To new mothers some birth injuries appear to be very serious but they miraculously disappear within the first week of life.
Though there are complications during delivery that may cause more severe damage to the child.
Complications that may cause birth injuries are:
- Prolonged or rapid labor
- Unusual birth position like breech birth.
- Mother’s pelvis is too small or has an abnormal shape.
- Large fetal head.
- Premature birth or too low birth weight.
- The umbilical cord is wrapped around baby’s neck.
Between 1970 and 1985 babies dying from traumatic birth injuries dropped by 88% thanks to ultrasonography and doctors doing more cesareans than instrumental deliveries.
The ultrasound scan was first introduced in the late fifties and is now one of the most useful tools to monitor pregnancies. The correct monitoring of mother and child during delivery has reduced the risk of birth injuries significantly.
Recent birth injury statistics show that yearly about 6 out of every 1,000 births in the U.S. results in various traumatic birth injuries.
In some cases birth injuries are caused by the doctor or nurses failing to react correctly when a baby is in distress.
Common traumatic birth injuries
Injuries to soft tissues
Injuries to the baby’s head and face are very common with all the pressure on baby’s face passing the birth canal.
Caput succedaneum is a large swelling on the infant’s head caused by the pressure of the wall of the vagina during delivery.
The swelling is usually on the part of baby’s head that comes first.
Often we see a Caput succedaneum after prolonged delivery or due to vacuum extraction. Fortunately the swelling will go away on its own.
A cephalohematoma appears as a lump on the head and is often the result of a vacuum and forceps-assisted delivery.
Excessive force or traction during delivery may result in the tearing of tiny bloodvessels.
Bleeding causes a collection of blood between the skull and the scalp. Normally a cephalohematoma resolves itself within 6 weeks.
With a large cephalohematoma there is an increases risk of anemia and jaundice.
Sometimes we see a red coloring around the iris in newborns. This happens when a small bloodvessel breaks near the white of the eye due to pressure during delivery. This has no affect on baby’s vision and will disappear on its own.
Cranial nerve injury - Facial paralysis.
Due to a great amount of pressure put on the child’s face, it is possible for a baby to suffer traumatic birth injuries such as Facial nerve palsy (damage to the 7th cranial nerve).
The position in the womb, high birth weight or the pressure used on baby’s face with a forceps can damage facial nerves. Especially when a baby cries you notice asymmetry in the face because one part of the face can’t move.
In most cases treatment is not needed, the problem is temporary and clears within a few weeks. Luckily severe injuries that require surgical repair to correct the problem are rare.
Brachial plexus injury –Erb's Palsy
Brachial plexus nerves are the nerves that travel from the neck and down the arm and control movements of the arms and hands. These nerves can get damaged in the doctor’s attempt to free the baby’s shoulder that is stuck behind the mother’s pelvic bone (shoulder dystocia).
Erb's palsy the most common form of brachial plexus injury, affects the muscles of the upper arm.
Klumpke's palsy affects the elbow and forearm with a distinctive claw-like deformation of the hand.
Most brachial plexus traumatic birth injuries are temporary. The majority of these nerve injuries resolve within two weeks to 12 months. A small percentage results in permanent injury and is treated with physical or surgical therapy.
Spinal cord injuries
Damage to the spinal cord is rare and often results in stillbirth.
The breech position has a heightened risk for developing spinal cord injury because of excess longitudinal traction to the spine.
Damage higher on the spine is far more dangerous because of a child’s inability to breath and is therefore often fatal.
The most common bone injury is a broken collarbone. The clavicle bone (collarbone) may break during a difficult delivery.
This happens more often with breech delivery and shoulder dystocia. Breaking of long bones of the arms or legs is highly unusual.
Brain injury from birth
There are traumatic birth injuries where lack of oxygen or blood loss causes damage to the brain tissue. Pressure on the umbilical cord can lead to oxygen deprivation of the brain (fetal asphyxia).
This often happens when the cord is wrapped around the child’s neck. Still the majority of brain injuries happen when the baby is still in the womb and not during labor or delivery.
Studies show that the majority of newborn brain injuries originate from developmental or metabolic abnormalities, stroke and intracranial haemorrhage, infection, trauma, or combinations of these factors.
- Neonatal encephalopathy (NE)- this type of brain injury may cause breathing difficulties, poor muscle tone and reflexes, sub normal level of consciousness and often seizures. Whether it causes permanent neurologic impairment depends on the extend of the damage.
- Cerebral palsy- is a chronic developmental disability where part of the brain that controls muscle tone is damaged causing uncontrollable movement and posture.
Some times a traumatic birth injury causes stretching and scaring of the neck muscle one of the causes of congenital muscle torticollis.
The scar tissue is sometimes visible as a small lump that slowly resolves over a period of 5 to 21 months.
Can you prevent traumatic birth injuries?
Is it possible to prevent this kind of injuries? I recommend that you do some research before you decide on the right doctor to deliver your baby. Choose a doctor with a good reputation.
With a competent, experienced doctor you will heigthen your chances of a delivery without complications.
Get yourself familiar with what happens during the birthing process and possible complications. This will help you to ask your doctor the right questions about how he monitors for complications.
When do you need a birth injury lawyer?
When your child is injured at birth you will obviously have many questions. You will want to know what went wrong and if the injury could have been prevented.
Traumatic birth injuries can be devastating to new parents especially when the condition does not improve and they have the responsibility of caring for a severely injured child. But it can also be financially catastrophic for a family with all the medical bills.
In such a situation a birth injury lawyer may help to evaluate birth and delivery to decide whether the injury was due to medical error and you will be able to claim birth injury compensation.