Erb’s palsy is estimated to affect as many as 1 to 4 out of every 1,000 babies – more than Down Syndrome and Muscular Dystrophy – yet most people know nothing about this sometimes devastating birth injury. It is caused when there is a stretching or tear of one or more of the five brachial plexus nerves located in a baby’s neck and upper shoulder area that control movement and feeling in the arm. Paralysis occurs and can range from mild to severe depending on the number of nerves that have been damaged and the extent of damage. The most common cause of Erb’s palsy is excessive pulling by a physician on an infant’s head and neck during a difficult delivery to help the shoulders pass through the birth canal.
Risk Factors for Erb’s Palsy
There are a number of medical and physical conditions in the mother and baby that add to the risk for Erb’s palsy. Some of these include:
- Pre-existing diabetes or prior gestational diabetes
- Maternal weight greater than 180 pounds or significant pregnancy weight gain
- Macrosomia or prior macrosomia (large baby)
- A woman who has previously had a child
- Prior shoulder dystocia (baby’s shoulder gets stuck behind the mother’s pelvis during delivery)
- Mother short in stature
- Advanced maternal age
- Post term pregnancy
- Use of epidural
- Prolonged second stage of labor
- Protracted descent, failure of descent of head
- Use of forceps or vacuum extractor
Doctors are obligated to diagnose and inform a mother of Erb’s palsy risk factors
Standards of care require that a doctor evaluate a mother for Erb’s palsy risk factors. If present, the obstetrician must discuss them with the mother and also inform her of the options for labor and delivery, including earlier induction of labor or the possible need for a C-section. Failure to do so is not only medical negligence. It can also produce devastating results.
One such tragic case occurred last February when a mother (Kellie) gave birth to her first child (Kiara). Labor was lengthy and difficult and resulted in a shoulder dystocia (the baby’s shoulder became stuck behind the mother’s pelvis bone). The doctor continued with a vaginal birth and baby Kiara was born with a paralyzed right arm.
Afterwards, the family was told by the doctor that it was simply a birth injury. Kellie stated, “We had no information about what had happened and had no awareness of the risk factors and possible consequences of shoulder dystocia or Erb’s palsy.”
Kellie had a number of problems during pregnancy and estimates that these constituted about 90% of the risk factors for Erb’s palsy. The obstetrician never told her that she was at an increased risk for shoulder dystocia nor Erb’s palsy. “I would have planned my delivery method differently had I been informed.”
Baby Kiara has had a rough time since her birth. “We have had a horrific journey with Kiara. She has had to endure surgery, physiotherapy and pain and will for the rest of her life.” Although she has regained some movement in her arm, it will take some time to determine how much recovery she will make and if she will require additional surgery.
Knowing the options may reduce the occurrence of injury
Erb’s palsy is a preventable condition. When it’s properly diagnosed and treatment options are planned and discussed with the mother, injury can be avoided. Kellie put her trust in her doctors that they would be forthcoming with potential risks and treatment options. Unfortunately, the doctor did not perform to the required standards of care and baby Kiara suffered as a result. Says Kellie, “As a mother, it is mortifying knowing that this could have been avoided if I was more informed.”
If you gave birth to a child diagnosed with Erb’s palsy and were not informed of risk factors and delivery options, call Reiter & Walsh ABC Law Centers at (888) 812-6009. Our specialized birth injury attorneys will review your child’s case and determine if his or her condition is a result of a medical mistake.