Most birth injuries are mild and temporary, but in rare instances, they can be serious and permanent.

Hypoxic Ischemic Encephalopathy

Hypoxic ischemic encephalopathy, also known as HIE, is a temporary or permanent brain dysfunction caused by a lack of oxygen and blood in the brain. It is often the root of other birth injuries, including cerebral palsy, epilepsy, and intellectual disabilities. Birthing complications that cause HIE include:

• Umbilical cord issues
• Placental abruption or bleeding
• Uterine rupture
• Abnormal fetal position
• Prolonged labor
• Use of forceps

Cerebral Palsy

Cerebral palsy is a disorder caused by damage to the portion of the brain that controls movement. This occurs when the brain is deprived of oxygen. Common causative factors include:

• Bleeding in the brain
• Umbilical cord issues
• Head trauma

Klumpke Paralysis

Klumpke paralysis is an injury to the brachial plexus, a network of nerves in the shoulder and neck that affects the movement of the lower arm and hand. Common causes include shoulder dystocia, forceps-assisted delivery, and prolonged labor. It is often temporary, but some cases require surgery or remain permanent.

Erb’s Palsy

Erb’s palsy is a brachial plexus injury that affects the movement of the upper arm. The causes and prognosis are similar to Klumpke paralysis.

Brachial plexus injuries that include upper- and lower-arm and shoulder areas are called global or total brachial plexus palsy.

Seizure Disorders

Brain damage from head trauma or deprivation of blood or oxygen can lead to seizure disorders, most commonly parietal lobe epilepsy and infantile spasms. Seizures may be temporary, but permanent seizure disorders may occur if brain damage is substantial.

Intellectual Disabilities

Brain damage during birth can cause severe intellectual disabilities that result in institutionalization at a young age and short life expectancy.

Spinal Cord Injuries

Spinal cord injuries can be catastrophic, leading to permanent paralysis and a short lifespan. Spinal cord damage typically occurs in the upper or middle cervical spine. Causes include:

• Improper forceps or vacuum extractor use
• Excessive rotation
• Hyperextension of the neck from shoulder dystocia or breech delivery

Bone Fractures

The most common bone fractures during birth are skull and clavicle fractures. Skull fractures present a risk for brain damage but are not always serious. Clavicle fractures usually heal without complications. Bone fractures are caused by shoulder dystocia and forceps delivery.

Intracranial Bleeding

Head injuries during delivery can lead to bleeding inside the skull. These injuries are most often caused by forceps or vacuum extraction, with vacuum extraction carrying the highest risk. Intracranial bleeding is a general term divided into subcategories.

• Cephalohematoma – a blood mass that develops under the scalp, which usually resolves itself.
• Subgaleal Hematoma – an accumulation of blood between the skull and skin on the scalp that requires immediate treatment.
• Subarachnoid Hemorrhage – bleeding between the brain and surrounding membrane, which could cause permanent brain damage or death if untreated.
• Subdural Hemorrhage – a potentially serious bleed between layers of the skull and the brain.

Facial Paralysis

Facial paralysis, also called facial nerve palsy, is the loss of muscle control on one or both sides of the face caused by pressure on the nerve. This is usually temporary but may require surgical intervention. The primary risk factors include:

• Large baby
• Long labor
• Epidural anesthesia
• Medication to induce labor or strengthen contractions