Birth Injuries

The moment of birth is a highly anticipated moment when you meet the newest member of your family. This moment can be traumatic if your baby suffers a serious birth injury. Birth injuries occur in 0.6-0.8% of births and account for less than 2% of neonatal deaths. While most birth injuries are minor and temporary, serious injuries can have lifelong implications for you, your family, and your baby.

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What causes birth injuries?

Birth injuries occur when your baby is injured by mechanical forces or deprived of oxygen or blood flow during birth.

Mechanical Extraction

Forceps or vacuum-assisted delivery is sometimes used to speed delivery as an alternative to a Cesarean section.


When used correctly, injuries do not occur or are minor and temporary. Common forceps injuries include:

  • Minor facial bruising
  • Temporary paralysis or weakness of the face
  • Temporary eye paralysis

Improper forceps use can cause serious injuries, including:

  • Skull fractures
  • Brain bleeds
  • Seizures
  • Nerve injuries in the neck and shoulders
  • Spinal cord injuries

Vacuum Extraction

Injuries from vacuum extraction include benign retinal hemorrhages and intracranial bleeding.

Birth Asphyxia

Birth asphyxia occurs when blood flow is disrupted for too long. The resulting oxygen deprivation can cause temporary or permanent damage to the baby’s brain and vital organs. Complications that can cause asphyxia include:

  • Low maternal blood oxygen
  • Premature placental separation
  • Long or difficult delivery
  • Umbilical cord issues
  • Maternal or fetal infection
  • Maternal hypotension or hypertension

Shoulder Dystocia

Shoulder dystocia occurs when the shoulders become stuck in the birth canal. The most common injury is nerve damage in the neck and shoulders. Less common injuries include asphyxia, central nervous system injuries, and long bone injuries.

Shoulder dystocia occurs in 0.5 to 1.5% of births. Risk factors include excess maternal weight, maternal diabetes, long labor, and a large baby.

Types of Birth Injuries

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 Hemorrhagebleeding 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

Who is at risk for birth injuries?

Birth injuries can happen to anyone. However, they are most common during complicated deliveries. The following factors increase the risk for complications:

  • Extreme maternal age (below 16 or above 35)
  • Large baby – birth weight larger than 3,800 grams (8.3 pounds)
  • Cephalopelvic disproportion – when the pelvic region is small compared to the baby’s head size
  • Maternal obesity
  • Premature birth
  • Cesarean birth

Who is liable for birth injuries?

Most birth injuries are caused by errors during childbirth. Any health care provider whose mistakes or negligence harm your baby is liable. This includes:

  • Doctors
  • Midwives
  • Nurses
  • Medical technicians
  • The hospital or birthing center itself

Common mistakes that lead to birth injury

The most common errors that lead to serious birth injuries are:

  • Improper forceps or vacuum extractor use
  • Improper fetal rotation, especially when using forceps
  • Waiting too long to perform a Cesarean
  • Lack of fetal monitoring
  • Misdiagnosing or failure to diagnose conditions during pregnancy
  • Administering the wrong medication or incorrect dose
  • Failure to get your informed consent
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What is medical malpractice and what do I have to prove?

Medical malpractice occurs when a health care provider causes harm through medical errors. This is also known as negligence. To show negligence, you need to prove the following:

  • Duty of care – an obligation to provide the standard of care exists
  • Standard of care – the level of care or course of treatment that is expected of a reasonable practitioner under the circumstances
  • Breach of duty – failure to provide the obligatory standard of care
  • Proximate cause – the injuries would not have happened except by the breach of duty
  • Financial damages – verifiable financial consequences

Do I need a lawyer to represent me in a malpractice case?

Medical malpractice laws are complicated. Your case will require an understanding of the laws and medical records, and your jurisdiction may require corroborating experts. Also, you will face time limits and documentation requirements.

Health care providers hire expensive lawyers in hopes of escaping liability. This places you at an unfair disadvantage if you are without a qualified attorney. The attorneys at Meadow Law Firm have the dedication and expertise to hold your providers accountable and ensure you and your baby get the compensation you need. Contact us today for a free case evaluation.

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