Birth injuries can be caused by many things, including hypoxic-ischemic encephalopathy (HIE) and fetal oxygen deprivation, trauma from impact during delivery, premature birth, infections or health conditions in the mother, medical negligence, and more. These injuries can impair the baby’s body systems, with impacts ranging from mild bruising and lacerations to permanent injury or lifelong disability.
Causes of Birth Injuries
Birth injuries can result from a wide variety of factors. Before discussing the causes of birth injuries, it’s important to understand exactly what birth injuries are. In this section, we’ll list a handful of birth injuries.
Some common birth injuries (that often are associated with medical negligence) 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. 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. Conditions that can cause oxygen deprivation in the womb are uterine rupture, placental abruption, placenta previa, umbilical cord problems, oligohydramnios, preeclampsia, premature rupture of the membranes (PROM), prolonged and arrested labor, and uterine hyperstimulation or tetanic contractions that occur when Pitocin or Cytotec are used and cause constant contractions. This can also be caused by medical professionals’ failure to identify fetal heart rate problems. To prevent fetal oxygen deprivation and hypoxic-ischemic encephalopathy, 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 group of disorders of the brain and nervous system that impairs functions such as movement, cognition, sight, and hearing. It is a disability that often is caused by brain trauma and bleeds, oxygen deprivation (hypoxia), and brain toxins. Cerebral palsy is associated with umbilical cord problems, placental abruption, uterine rupture, bleeding in the brain, HIE, brain infections, head injury, infections in the mother, and severe jaundice.
- Kernicterus: This is a permanent neonatal brain injury that occurs when too much bilirubin builds up in the baby’s body and enters the baby’s brain, which can result from improperly-managed jaundice. Bilirubin is toxic to the brain and can cause permanent injury when it moves into brain tissue. 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, resulting 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. The younger and smaller babies are, the more susceptible they are to PVL.
- Intellectual and developmental disabilities (I/DD): I/DD is a disability 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. Trauma and hypoxia can cause excess fluid in the brain, which can cause further brain damage.
- Infection: Maternal or fetal infections can cause permanent disability, injury, and brain damage.
- Traumatic birth injuries: Injuries that occur to an infant during delivery that are a result of mechanical forces such as compression, intense and frequent contractions, or traction are classified as traumatic birth injuries. The most common areas affected are the brain, spine, nerves and bones. A baby’s size (macrosomia) can increase the risk of trauma. In addition, cephalopelvic disproportion (the baby is too large for the size of the mother’s pelvis), position (such as breech or face presentation), and neurological frailty can complicate the birthing process. If not handled appropriately, traumatic injury can result. Use of forceps or vacuum extractors and labor induction drugs, such as Pitocin or Cytotec, can cause traumatic injury to the baby.
- Delaying or failing to order a C-section when a baby’s size, position (e.g. breech) or umbilical cord position (eg: compressed, prolapsed) makes vaginal delivery dangerous. Delaying delivery when other dangerous maternal or fetal conditions are present can also cause birth injury.
- Premature birth: Premature delivery can greatly increase the risk of birth injury to the baby. Physicians are required to recognize risk factors for premature birth and diagnose preterm labor, and they must follow standards of care to prevent premature birth. This may include administration of medications to do the following:
- Stop contractions (terbutaline and brethine)
- Mature the baby’s lungs (the steroid betamethasone)
- Prevent infection
Birth Injury Causes: Premature Birth
Babies born prematurely can have serious complications, such as immaturity of the lungs and brain. This can lead to respiratory distress syndrome (RDS) and apnea of prematurity, which can cause fetal oxygen deprivation. In addition, babies with these problems often are put on breathing machines, which can lead to overventilation injuries in these delicate babies. All these conditions can cause permanent damage in the baby, such as HIE and cerebral palsy. Furthermore, the younger and smaller a baby is, the more likely she is to develop periventricular leukomalacia (PVL).
Some common causes of prematurity include:
- Incompetent or weakened cervix (pressure from the baby’s weight causes the cervix to start to open before the baby is ready to be born).
- Infection: Some infections, such as herpes simplex virus (HSV) and Group B Strep (GBS) can be transmitted to the baby through the birth canal if left untreated. Sepsis, meningitis, and encephalitis are the most serious conditions that can occur when infection is transmitted; these conditions can cause permanent brain damage.
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
- Medication errors
- Incorrect use of delivery instruments such as forceps and vacuum extractors
What Caused Your Baby’s Birth Injury?
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