A birth injury is any type of harm to a baby that occurs during or near the time of birth. It can be caused by many things, including fetal oxygen deprivation, trauma from impact during delivery, premature birth, medical negligence, and more. These injuries can impair the baby’s internal systems, with impacts ranging from mild bruising and lacerations to permanent injury or lifelong disability.
Common birth injuries and their causes
Birth injuries can result from a wide variety of factors. In this section, we’ll list a handful of birth injuries and their causes.
Some common birth injuries include:
- Hypoxic-ischemic encephalopathy (HIE): HIE is a dangerous neonatal brain injury that occurs when the baby’s brain is deprived of oxygenated blood at or near the time of delivery (i.e. experiences birth asphyxia). HIE and other types of brain injuries caused by oxygen deprivation can occur when a baby is not receiving enough oxygen in the womb and the physician fails to quickly deliver the baby by emergency C-section (1). Conditions that can cause oxygen deprivation in the womb include uterine rupture, placental abruption, placenta previa, umbilical cord problems, preeclampsia, and others. HIE can also be caused by medical professionals’ failure to identify fetal heart rate problems. To prevent fetal oxygen deprivation and HIE, a baby’s heart rate should be continuously monitored during labor and delivery. Nonreassuring fetal heart tracings are an indication of fetal distress, and fetal distress almost always means the baby is oxygen-deprived. When this occurs, the baby must be delivered right away, usually by emergency C-section.
Other causes and types of birth injuries include:
- Cerebral palsy: Cerebral palsy is a type of motor (movement) disorder caused by brain damage or abnormalities. Conditions that can cause cerebral palsy include umbilical cord problems, placental abruption, uterine rupture, bleeding in the brain, HIE, head injury, infections in the mother, and others.
- Kernicterus: This is a permanent neonatal brain injury that can be caused by improperly-treated jaundice (excessive bilirubin in the baby’s blood). Kernicterus can cause cerebral palsy.
- Brachial plexus injuries and Erb’s palsy: These birth injuries occur when too much force is applied to the baby’s head and neck during delivery, and the force causes nerves in the shoulder area to be torn. This can result in paralysis or weakness of the baby’s arm.
- Periventricular leukomalacia (PVL): PVL is characterized by permanent injury to the white matter in the brain. It is caused by oxygen deprivation or trauma.
- Intellectual and developmental disabilities (I/DD): I/DDs are disabilities characterized by profound limitations in cognitive function and adaptive behavior. Brain damage caused by oxygen deprivation, trauma, infection, and brain toxins can cause intellectual and developmental disabilities.
- Intracranial hemorrhages (brain bleeds): Trauma to the head during delivery can cause several different types of bleeds in the brain, which can, among other things, deprive the baby’s brain of oxygen-rich blood and cause brain damage.
- Hydrocephalus: This is excess fluid in the brain caused by trauma to the head or oxygen deprivation in the brain.
- Infection: Maternal or fetal infections can cause permanent disability, injury, and brain damage.
- Traumatic birth injuries: This is a subcategory of birth injury caused by excessive mechanical force during delivery. The risk of traumatic brain injury increases when:
- The baby is large (macrosomia)
- The baby is too large for the size of the mother’s pelvis (cephalopelvic disproportion)
- The baby is in an abnormal position (such as breech or face presentation)
- The baby has neurological frailty which is not handled properly by medical professionals
- The doctor employs the use of forceps or vacuum extractors
- The doctor employs the use of labor induction drugs, such as Pitocin or Cytotec
- Delaying or failing to order a C-section When a vaginal delivery is dangerous (because of a baby’s size, position, breathing, umbilical cord position, or another circumstance), a C-section must be administered immediately. Delaying delivery when other dangerous maternal or fetal conditions are present can cause birth injury.
Premature birth and birth injury
Babies born prematurely (before 37 weeks gestation) can have serious complications, such as immaturity of the lungs and brain (2). This can lead to respiratory distress syndrome (RDS) and apnea of prematurity, which can cause fetal oxygen deprivation. In addition, babies with these problems are often put on breathing machines, which can lead to overventilation injuries. All of these conditions can cause permanent damage to the baby, such as HIE and cerebral palsy. Furthermore, younger and smaller babies are more likely to develop periventricular leukomalacia (PVL).
Premature delivery can greatly increase the risk of birth injury to the baby. Physicians are required to recognize risk factors for premature birth, diagnose preterm labor, and follow standards of care to prevent premature birth. This may include administration of medications to do the following:
Negligence during pregnancy, labor, and delivery can cause birth injuries
Medical professionals must closely monitor both the mother and the baby around the time of labor and delivery. When delivery complications arise, it is the responsibility of the physicians and medical team to act quickly and appropriately to minimize the risks to the mother and baby. Failure to follow medical standards of care is medical negligence. Some examples of medical negligence include:
- Failure to identify and plan for complicated or high-risk deliveries
- Failure to diagnose and treat problems prior to delivery
- Failure to recognize and address problems with the umbilical cord
- Failure to order a timely C-section when necessary
- Failure to identify and adequately respond to fetal distress/nonreassuring fetal heart tracings
- Failure to diagnose and/or stop preterm birth
- Failure to diagnose maternal medical conditions
- Failure to properly treat excessive bilirubin in a baby
- Improper use of Pitocin or Cytotec
- Other medication errors
- Incorrect use of delivery instruments such as forceps and vacuum extractors
What Caused Your Baby’s Birth Injury?
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Related Birth Injury Resources
- Hypoxic-Ischemic Encephalopathy: Practice Essentials, Background, Pathophysiology. (2018, July 26). Retrieved from https://emedicine.medscape.com/article/973501-overview
- Premature birth. (2017, December 21). Retrieved April 29, 2019, from https://www.mayoclinic.org/diseases-conditions/premature-birth/symptoms-causes/syc-20376730