Birth Injury Overview – What You Need to Know

Bringing a newborn into this world is one of the few moments of true magic we get to experience as a human. It is not without anticipation and concern, but we place our trust in the medical profession and our doctors to keep our newborns safe as they journey from the womb to start their new life. 

According to a report published on PubMed.Gov, the rate of birth injury is decreasing. With these advances, in 2012, the rate of birth injuries still stood at 1.9 per 1000 live births. Many other reports show a higher frequency at 7-10 injuries per 1000. PubMed.Gov indicated that the frequency of forceps and vacuum-assisted deliveries has also decreased in the last thirty years. 

The United States sees approximately 4 million babies born a year. Using the rate of 1.9/1000, this would come to around 7,600 potential birth injuries a year. Some injuries are unpreventable, but the birth trauma rate reduced recently. Combining this information with a connection to the methods used in delivery, one questions if a child’s birth injury is avoidable.

What is a birth injury?

A birth injury or birth trauma is when an injury occurs during the birthing process. Both the mother and the infant are susceptible to birth injuries, although the term generally refers to an infant’s injury. A birth injury is not the same as a birth defect, or abnormality due to genetic wiring or predisposition.

There is a myriad of complications that could arise during labor and delivery. Most of the birth injuries are a direct result of these complications. Generally speaking, doctors and medical professionals have received extensive training and work diligently to prevent any such complications from arising. In some unfortunate situations, the birth injury could have been avoided and is a result of negligence.

Why do birth injuries occur?

Often birth injuries or birthing complications are unpredictable; however, some factors increase the risk of birth trauma and injury. While the presence of one of these factors does not guarantee a birth injury, statistically speaking, it does yield a higher chance.

Mother and baby’s size

When the baby is particularly large, or the mother is small or has narrow hips, there is an obvious risk of complications. In 10% of pregnancies, fetal macrosomia, or an overly large baby for its gestational age, occurs. Fetal macrosomia is when the baby weighs over 8 lbs 13 oz. This largeness can create a situation in which the baby is too big to pass through the birthing canal. In other cases, the mom’s birth canal may be too small, or her pelvis may be misshapen, causing the baby to get stuck.

Another situation from fetal macrosomia is shoulder dystocia, or when the baby’s head passes through but the shoulders get stuck. Risks due to shoulder dystocia include fractures in the collarbone or upper arms, nerve damage, brain damage, or even death in rare cases. The mother is not free from the risk of injury, including ruptures and tears, and heavy bleeding.

Cephalopelvic Disproportion (CPD) occurs when the infant’s head is too large to pass through the mother’s hips. The condition is not common, affecting 1 in every 250 deliveries. In many cases, the baby is delivered through a cesarean section once CPD is established. 

Despite the reason behind the mismatch of baby’s size and birthing canal, when a baby cannot pass through properly, there is a risk of cutting off the oxygen supply to the infant. Should this happen, doctors often attempt to remove the baby using forceps or a vacuum extractor pump. Misuse of these instruments can cause birth injury, leading to negligence claims.

Preeclampsia or maternal infections

Toward the end of pregnancy, some women develop high blood pressure that quickly worsens. Preeclampsia afflicts about 9% of all pregnancies. Babies born to a mother experiencing preeclampsia find themselves at higher risk for brain damage or other oxygen deprivation injuries. 

Maternal infections operate at much the same notion. If there is an infection during childbirth, there is a higher chance the child will have an issue with the placental or fetal membranes. This issue can, in turn, cause severe changes to the oxygen supply. A situation where the infant has a decreased supply of oxygen can result in injuries such as cerebral palsy.

Abnormal positioning

Babies are supposed to exit the mom head-first. Sometimes though, the babies don’t turn or are positioned awkwardly. Other times, the umbilical cord wraps around the neck. These positions lead to complications with the birth. Due to positioning, the baby may lack oxygen, opening up potential birth injury.

Gestational diabetes

Gestational diabetes occurs during pregnancy, and so far, researchers do not know why it transpires. During this time, pregnant women have a much harder time processing sugar. The babies of women with gestational diabetes are at increased risk for dystocia and macrosomic babies. Brachial plexus trauma, an injury to the nerves that allow signals to travel from the spinal cord to the arm and shoulder, becomes more common.

Pitocin and epidurals

With natural birth, the body releases oxytocin. This hormone triggers the uterus to begin contractions. When labor is induced, doctors administer Pitocin to deliver the same result. 

The issue comes when the body over-responds to the Pitocin. The uterus responds with an abundance of contractions, both too intense and frequent. The result is a risk of decreased oxygen for the baby and a chance of pushing the infant through the birth canal too quickly. Low oxygen increases the likelihood of birth injuries such as cerebral palsy, brain damage, or death.

Epidurals are when a needle is essentially taped to the epidural space around the spine. Through this needle, the mother receives numbing medication, so the lower half of the body is not felt. 

While the epidural itself is safe, the danger falls when the body is so numb the mother is incapable of pushing the baby out. Time extends, creating stress on the baby and an increased chance of oxygen deprivation. If the pushing phase takes too long or the mother becomes too exhausted to continue, doctors may use forceps or a vacuum, increasing the chance of birth injury.

Birth injury statistics

Many statistics on birth injuries are outdated. Even newer articles quote statistics found over a decade ago. Articles often post old statistics, because frankly, the search to find updated information is equivalent to searching for water in a desert. 

In the last decade, advancements in technology allow for the recognition of potential issues. In turn, the use of forceps and vacuum usage decreased, resulting in fewer birth injuries. 

• 15 in 1000: the number of clavicular fractures in live birth. Clavicle fractures represent the most common bone fracture taking place during delivery.
• 10 in 1000: the number of facial nerve injuries; a type of cranial nerve injury and is often due to the use of forceps or the shape of the mother’s pelvis.
• 2.5 in 1000: the number of brachial plexus injuries during live births. Macrosomia, shoulder dystocia, difficult delivery, and breech position all increase the risk of brachial plexus injuries.
• 5.9 in 1000: number of subgaleal hemorrhages due to vacuum-assisted deliveries. 60 times more likely for an infant to have a subgaleal hemorrhage when using a vacuum-assisted extraction than any other type of assistance.
• .4 in 1000: number of subgaleal hemorrhages due to vaginal deliveries.
• 2.5%:the percentage of deliveries resulting in cephalohematoma. Cephalohematoma is generally a minor condition but increases its risk of occurring with the use of forceps and a vacuum.
• 3%: the percentage of accidental soft tissue lacerations occurring during cesarean sections; more common in emergency deliveries versus scheduled deliveries.
• 1 to 4 in every 1,000: number of live births worldwide resulting in cerebral palsy. 3 in 1000 US children identified as having cerebral palsy.
• 7%: the percentage of birth injuries diagnosed in the first year of life.
• 14%: the additional percentage of birth injuries diagnosed once the child is school-aged.
• 1.9 in 1000: the ratio for birth trauma injuries as of 2013, falling from 2.6 in 1000 in 2004.

Most common birth injuries

According to Standford Children’s and the University of Rochester’s Medical Center, the most common birth injuries are as follows: bruising or swelling of the head, bleeding underneath the top portion of the skull (cranial bone), small blood vessels breaking in the baby’s eyes, injuries to the facial nerves or facial paralysis, damage to nerves linked to arms and hands, and collarbone fractures. 

Columbus, Ohio’s Chamber of Commerce includes Cerebral Palsy as a common birthing injury. The site also specifies Hypoxic Ischemic Encephalopathy (HIE), or oxygen deprivation due to an extended period in the birthing canal or lack of monitoring, as frequent birth trauma. 

Most birth injuries are minor such as scratching and bruising. Some are unfortunate byproducts of an unexpectedly complicated birth. When the birth injury results from negligence, a lawyer’s help is needed to navigate the complex waters of pursuing justice for what should never have been.

Birth Injury Cases

In 2019, Coverys released a report analyzing 470 claims from 2013-2017 involving pregnancy, postpartum, and childbirth. They found negligence accounted for 40% of the claims. Between vaginal birth, cesarean sections, and emergency cesarean sections, vaginal births produced the most claims at 52%. They classified the injuries into three categories: neurological or brain damage (41%), shoulder injuries (37%), and death or stillbirth (34%).

80% of the claims were for severe cases such as cerebral palsy, neonatal blindness, hearing impairment, and loss of fertility for the mother. 58% of the claims proved to display a known risk factor such as diabetes, obesity, or high blood pressure. 

While these statistics are worth noting, proving a birth injury is difficult. Parents assume the damage was entirely unavoidable or do not believe they have enough information to prove their case. Picturing a medical malpractice claim, let alone navigating it, is unthinkable. This is where an experienced birth injury lawyer comes into play.

Four requirements of medical malpractice

• A professional duty was owed to the patient – this is the easiest of the four requirements to establish as the mother checks into the hospital to deliver her baby. At this point, a professional duty is set.
• There was a breach of such duty – this is where negligence comes into play. Sometimes the violation is a failure to test appropriately or to create a treatment plan without proper testing or consideration of the results. Other times it is giving incorrect medication or improper dosages or even not providing the treatment promptly.
• An injury was caused because of this breach – this is essentially stating the injury must be due directly to the negligence. It cannot simply be there was negligence or injury. The two must be connected. 
• There are damages resulting from such breach –  the most obvious of these being the medical damages or loss of income due to the injury. Pain and suffering, loss of enjoyment, and mental anguish are costs that do not have a concrete number attached, and the victim and family may still be owed this compensation.

Birth Injury Lawsuits

Birth injuries are a division of medical malpractice requiring a birth injury attorney versed in the intricacies of the field. They work to take your birth injury claim and build a case to prove that the birth injury resulted from negligence. After that, should you choose to pursue, the attorney will file the suit in a court of law.

The time frame of your lawsuits varies. Some may take just a few months, while others may drag for years. The lawyer must gather medical records, timelines, statements, and all the facts possible before starting. Depending on the intricacies of the case, it may take some time. 

Birth Injury Statute of Limitations

It is essential not to delay should you feel a birth injury occurred. Some states have statutes of limitations on birth injury lawsuits. Since not all birth injuries are at the actual birth, most states begin this time frame when the birth injury is discovered. If your time frame is close to running out, some lawyers will not take the case. To be sure, it is best to file right away.

Birth Injury Settlements

The advantages to settling out of court are time and quicker compensation. With something as heartwrenching as your child’s injury, a long, drawn-out process may be something too emotional to bear. Depending on the circumstances of the injury, it may simply not be possible. If your case requires a lengthy court case, by the time the case is complete, the potential compensation may be greatly reduced, if available at all. 

The Hayes Firm is here for you

Our firm is experienced in matching the right lawyers to the right clients. With a case as delicate as your child, it is imperative you find an attorney specialized in birth injury lawsuits. With proven track records of locating the right attorney for cases, you can rest assured we will fight for justice and the compensation you deserve.

Contact The Hayes Firm today. Time matters; don’t let yours run out.