Injuries are a natural part of life, but they seem far less normal when they occur in newborns. While the majority of infants are born without injury and are able to go home with their parents in only a day or two, birth injuries affect approximately 7 out of every 1,000 babies. This sounds like a very low number. However, for those families affected, this is a traumatic experience to go through and is one that could create lifelong problems for the child as well as potentially lifelong financial commitments. If your child was born with a birth injury, it is critical to contact a birth injury attorney at McGehee ☆ Chang, Landgraf, Feiler so we can get you the compensation your family deserves.
Types of Birth Injuries
In general, the majority of birth injuries can be placed into the following categories.
- Physical Injuries
- Brain Injuries
- Pregnancy-Related Injuries
- Delivery-Related Injuries
Physical injuries most often affect the bones, muscles, and nerves of the infant, causing short-term or long-term side effects. Some of the most common physical injuries include bruising on the head, bleeding beneath the cranial bones, and swelling of the head. Certain delivery maneuvers can also lead to broken bones, most notably pelvic, arm or collarbone fractures as the baby is pushed through a narrow opening.
Shoulder dystocia is one common manifestation of this problem. In this case, the infant’s shoulders are caught inside the mother due to a poor presentation of the infant or due to the mother’s small pelvic bones. Infants with shoulder dystocia could have trouble breathing or could develop cerebral palsy. The mother could even hemorrhage or develop uterine rupture.
In addition, there are a variety of nerve-related injuries that occur in infants every year. Nerves may be stretched, compressed, or severed during delivery, leading to short-term or long-term paralysis. Some infants may only show weakness along one limb before healing. Brachial plexus is one of the most common nerve injuries affecting the arm. The brachial plexus is an intricate network of nerves that carries signals from the spinal cord to the entire arm. If these nerves are compressed or otherwise injured, the infant may have significant weakness and pain in the arm.
There are also specific types of brachial plexus injuries. Erb’s palsy is a brachial plexus injury occurring in the upper portion of the arm. This problem usually results in a complete loss of sensation throughout the arm. Klumpke’s palsy affects only the lower portion of the arm, most notably weakening or paralyzing the wrist, hand, and fingers. Some infants develop a permanent claw-like look in the affected hand.
Other nerves that could be affected include the facial nerves and laryngeal nerves. Facial nerve damage can result in a lack of movement and expression on a single side of the face. Laryngeal nerve damage affects the vocal cords and usually happens if the infant’s head is twisted to the side during childbirth. The infant may make hoarse crying sounds, but this problem should resolve in a few months.
Brain injuries are particularly serious because they can lead to long-standing problems for the child. Most brain injuries occur secondary to a lack of oxygen during the delivery. Common diagnoses related to this problem include anoxia and birth asphyxia. When a baby does not get enough oxygen delivered through the placenta during the birth, the brain is deprived of the life-giving nutrients that it needs, and parts of the brain may shut down. In some instances, blood vessels in the brain may hemorrhage or the brain could stop sending out electrical responses.
When the brain is no longer controlling the body efficiently, a newborn may develop seizures. In some cases, neonatal seizures are the only sign that a brain injury is present in the child. Diagnosis may be done with an electroencephalogram (EEG), magnetic resonance imaging (MRI) or computed tomography (CT). When the seizures do not resolve, infants may grow up to have epilepsy, which can be a long-lasting neurological disorder.
Another common problem associated with a lack of oxygen during delivery is cerebral palsy. Approximately 8,000 new cases of cerebral palsy are diagnosed every year. While there can be other causes for cerebral palsy, such as maternal infection, many causes are completely avoidable. However, when it occurs, cerebral palsy significantly affects muscle coordination along with gross and fine motor movement, leading to rigidity and spasticity.
Of course, brain injuries may show up in less obtrusive ways as well. The infant may have a low Apgar score after delivery, may appear blue or pale, may act lethargic, or may simply refuse feedings. Each of these problems should be checked out thoroughly as soon as they are noticed.
In some cases, birth injuries occur due to events that happened throughout the pregnancy. For example, insufficient blood flow through the placenta can lead to low birth weight and even oxygen-deprivation issues. Simple infections in the mother can turn lethal for a developing fetus. Even medications, drugs, alcohol, and other things that the mother ingests can create significant problems in some instances.
It is the physician’s responsibility to check for potential infections and problems that the mother could pass on to the infant during the pregnancy or the delivery. This is why pregnant women undergo so many urine and blood tests. However, there can be times that an infection is not diagnosed despite the best of intentions. For example, women may carry strep B infections in their vaginas without realizing it and can easily pass on the infection to the fetus passing through the birth canal.
In addition to problems that the mother can pass on to the infant, the fetus could also have physical problems during development that could and should be treated before delivery, such as folic acid deficiency and spina bifida. Many of these problems can lead to serious issues that can last for years or the rest of the infant’s life.
Finally, the delivery itself can be a very tumultuous time when things do not go the way that mothers and doctors planned. One of the most common ways that these injuries occur is through mechanical delivery assistance. When doctors choose to use a forceps or a vacuum extractor, the child often ends up with bruising, bleeding, and possibly even changes in the shape of the head. In some cases, the physician overlooks the need for a Cesarean section.
Of course, other delivery-related injuries are completely preventable, and they could include giving the wrong medication or poorly handling the newborn. Failing to read doctor’s orders fully, giving the incorrect dosage of a medication, or giving a medication to the wrong person can lead to serious injuries in certain cases.
Birth Injury Risk Factors
Although birth injuries can happen to nearly any infant, there are a few populations more likely to see these issues. For example, genetics and disease processes in the mother can play a huge role in certain injuries for both the infant and the mother. Birth injuries are most often seen in low-income communities where women cannot afford to take care of themselves or their fetuses with healthy food and food supplements. These women are often limited in their resources and cannot afford proper prenatal care. In addition, birth injuries are more common in rural areas where women cannot travel frequently to see their physicians or where they cannot get to a medical center quickly in the case of complications.
Other common factors associated with birth injuries include the following:
-Very large fetuses, including those weighing 9 pounds or more
-Preterm labor before 37 weeks gestational age
-Breech or face delivery positions
Preventing Birth Injuries
There are steps that both parents and medical practitioners can take to prevent or decrease the chance of birth injuries. For parents, proper prenatal, as well as labor and delivery care, is vital for a healthy infant. Mothers should be careful to avoid certain foods, drinks, activities, and exercises while pregnant. In addition, they should seek out early care from a qualified provider and should attend all scheduled appointments and tests. Having the recommended immunizations, laboratory tests and ultrasounds can ensure that the fetus stays healthy and that any problems are caught early.
Physicians and other people on the health care team should also monitor each pregnancy closely, especially in the case of high-risk pregnancies. During labor and delivery, the baby should be closely monitored to check for decreased heart rate and decreased movement, which could point to fetal distress. In some cases, pre-term birth can be avoided through medications, bed rest, or even cervical cerclage.
Finally, doctors must realize that vaginal births may be dangerous in certain instances, such as when the fetus is too large for the mother’s pelvis or in cases of maternal infections, placental previa, or prolonged labor.
Short-Term and Long-Term Effects of Birth Injuries
In many cases, birth injuries are easily treatable. Bones, muscles, and nerves may heal with no visible damage. Bruises fade, and weakened limbs become stronger.
However, there are numerous cases every year in which infants face irreparable harm due to complications or preventable injuries. Some are consigned to wheelchairs with cerebral palsy or are unable to participate in common childhood activities due to physical limitations. Even with quick treatment, birth injuries often lead to permanent disabilities. In some cases, they can even lead to an early death. Certain injuries may not be noticed for years and may only become apparent when a child starts school.
Thankfully, many children are able to live with their birth injuries, making adjustments in education and social interactions so that they can lead full lives even through adulthood. By working to avoid birth injuries in the first place, parents and physicians can help ensure great health and wellness in all children.
If your infant was born with a birth injury due to medical malpractice, contact us today for a consultation. We will help get you the compensation you and your baby deserve as you deal with this potentially life-altering diagnosis.