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Injuries to the infant that result from mechanical forces (ie, compression, traction) during the birth process are categorized as birth trauma. Factors responsible for mechanical injury may coexist with hypoxic-ischemic insult; one may predispose the infant to the other.
Significant birth injury accounts for fewer than 2% of neonatal deaths and stillbirths in the United States; it still occurs occasionally and unavoidably, with an average of 6-8 injuries per 1000 live births. In general, larger infants are more susceptible to birth trauma. A higher risk is
associated with larger infants, born with a birth weight of 4500g or
more.
Most birth traumas are self-limiting and have a favorable outcome. Nearly one half are potentially avoidable with recognition and anticipation of obstetric risk factors. Infant outcome is the product of multiple factors. Separating the effects of a hypoxic-ischemic insult from those of traumatic birth injury is difficult.
Head trauma is just one injury that may occur during delivery and can lead to a number of conditions
for the infant including caput succedaneum, cephalohematoma, normal head deformity due to birth forces, subgaleal hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage.
In addition to head trauma, there are also several other types of
birth injuries that can occur within any hospital environment.
Cerebral palsy is a term used to describe chronic, nonprogressive disorders appearing early in life, in which the main symptoms are abnormal control of movement and posture. Sometimes, Cerebral Palsy is caused by brain damage from lack of oxygen due to an event during labor or delivery. When this happens in full term babies, the newborn will have evidence of severe pH abnormality in the cord blood and neurologic abnormalities soon after birth. Frequently there will be signs of sudden oxygen deprivation seen on the fetal monitor, very low Apgar scores at birth, and involvement of other organs such as the kidneys within a few days.
Perinatal asphyxia occurs in 1 to 2.3 newborns out
of every 1000 births within the United States. Perinatal asphyxia occurs when gas exchange is impaired enough to cause significant metabolic acidosis. As asphyxia progresses, the fetus loses the ability to protect vital organs. Eventually there is a decrease in cardiac output. This, in turn, leads to marked hypotension and a sebsequent further decrease in blood flow to the heart and the brain, resulting in damage to the central nervous system. The severity can vary based on several factors, including the length of time and severity of compromised gas exchange, the underlying condition of the fetus, and the ability of noncirculatory mechanisms to protect brain cells and tissue from hypoxic injury and death. If the duration of time is prolonged and/or unrelieved, asphyxia will lead progressively to cellular death, tissue damage, organ and organ system failure, and ultimately, fetal death.
Erb’s Palsy can occur as a result of an abnormal or difficult
childbirth or labor. It is a paralysis of the arm caused by injury
to the upper group of the arm's main nerves. It can occur if the
infant's head and neck are pulled toward the side at the same time
as the shoulders pass through the birth canal. The condition can
also be caused by excessive pulling on the shoulders during a head
first delivery, or by pressure on the raised arms during a breech
(feet first) delivery. Erb's palsy can also affect neonates affected
by a clavicle fracture unrelated to dystocia.
Brachial plexus palsy occurs in 0.4 to 5.1 infants for every
1,000 children born. Brachial plexus injuries can occur as a
result of shoulder trauma, tumors, or inflammation. Brachial
plexus injuries may happen during birth if the baby’s shoulder is
stretched during passage in the birth canal.
The most common fracture that can occur during delivery is that of
the clavicle.
When an infant is injured during birth, it is usually as a result of mechanical forces, such as compression,
excessive or abnormal traction during delivery, the use of forceps
(especially mid-cavity), instrumental deliveries, vacuum measures,
vaginal breech deliveries, and other devices used by the medical staff during delivery.
Meconium aspiration syndrome is a leading cause of severe
illness and death in a newborn. The possibility of inhaling meconium
occurs in about 5-10% of births. It typically occurs when the fetus
is stressed during labor, especially when the infant is past its due
date. Meconium aspiration syndrome is a serious condition in which
a newborn breathes a mixture of meconium (first feces or stool) and
amniotic fluid into the lungs around the time of delivery.
A birth trauma can be both an emotional and daunting experience
for all family members.
Anyone who has been the victim of a birth trauma that has resulted
in a head injury, birth injury, or cerebral palsy diagnosis, as the
result of medical negligence, is eligible to recover medical and
hospital expenses to cover the care of the child. If the birth
injury was caused as a result of the medical staffs’ failure to
properly identify the risk factors, as the result of surgical errors
or anesthesia errors, the family may also recover medical and
hospital expenses. The first step is to have your case evaluated by
an experienced law firm to find out your legal options.
The following sections explain:
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