Things Parents Should Know About Birth Injuries

According to the National Vital Statistics Report, a birth injury occurs when a neonate’s body function or structure is impaired during birth.

In simpler words, a birth injury or ‘neonatal birth trauma’ is any form of harm experienced by the baby immediately before, during, or after delivery. Birth injuries in the U.S. occur in 7 out of every 1000 births.

Some of these injuries are temporary and short-lasting. However, others permanently affect your baby’s physical, emotional or cognitive development.

Who Is To Blame?

In the unfortunate event that your baby suffers an injury during birth, the first step is to determine whether medical negligence was involved. It is crucial to seek legal and financial aid. 

Healthcare professionals are under oath to identify the risks of birth injuries and take precautions to prevent them. So, if the accident is a consequence of your doctor’s negligence, that case falls under medical malpractice.

How Should You Proceed?

Unaware parents often find themselves helpless. With the undoubted affliction of knowing the baby’s inevitable suffering throughout life, they have another thing on their minds: medical and financial assistance. 

The first step in such a challenging situation is to seek legal and financial support.

For instance, if your baby suffers from brachial plexus damage, you must immediately get in touch with an Erbs palsy lawyer. A lawyer adept at handling special cases can get you the compensation you need for treatment.

Because of a healthcare personnel’s negligence, your child could be a victim of structural abnormalities, restricted growth, or nerve damage. Suing the doctor who failed to prevent the injury will help reveal the hospital’s lack of standards of care, preventing other parents and children from suffering unnecessarily.

Predisposing Risk Factors For Birth Injuries

Not all birth injuries are caused by medical negligence. It is important to know what factors contribute to a birth injury so you, as parents, can also take preventive measures and ensure the safety of your child. 

Some of these factors may be related to the fetus or the mother.

Fetal Factors

• Macrosomia – a newborn baby weighing more than 4000g at birth
• Microsomia – an extremely low birth weight
• Macrocephaly – an abnormally large head
• Premature birth
• Breech – a malpositioned fetus that makes for a difficult delivery and requires excessive and atypical force by the physician
• Fetal distress caused by hypoxia
• Congenital abnormalities

Maternal Factors

• Primiparity – giving birth for the first time
• Geriatric pregnancies
• Small maternal stature
• Maternal pelvic abnormalities
• Gestational diabetes
• Oligohydramnios – lower than normal amniotic fluid levels during the pregnancy
• Maternal infections
• Unusually rapid or prolonged labor
• Assisted birth – use of forceps or ventouse (vacuum) during delivery

What Are The Signs Of A Birth Injury?

Birth injuries can become a source of lifelong turmoil for the child and parents.

If you fear your baby has become a victim of defects during birth, get it diagnosed immediately. A timely diagnosis can alleviate symptoms and ease a patient’s prognosis.

Watch out for these signs to detect a birth injury: 

Signs at Birth

• Paleness or cyanosis of the skin
• Slow respiratory rate and heart rate
• Sluggish or absent reflexes – lack of response to stimuli such as sound
• Low APGAR scores
• Seizures
• Photosensitivity
• Lethargy or fussiness
• Hypertonic or hypotonic muscles
• Difficulty swallowing or excessive drooling

Signs at 1-2 Years of Age

• Impeded speech development
• Subpar intellect
• Difficulty crawling or walking
• Loose grasp – due to hampered muscle control
• Ataxia – lack of movement
• Lack of response to stimuli
• Vision and hearing challenges

If you observe any of the signs mentioned above, contact a pediatrician immediately to get the symptoms under control if not eliminated.

Most Common Birth Injuries

Birth injuries can be mechanical, hypoxemic, or ischemic. Consequently, injuries can occur to the head, neck, cranial nerves, face, musculoskeletal system, or soft tissues. Linear or disrupted fractures, especially of the skull, are also commonplace.

1. Erb’s Palsy or Brachial Plexus Injury

Named after William Erb, the man who first described the condition, Erb’s Palsy affects 0.9 to 2.6 percent of every 1000 births. It is caused by applying misdirected, excessive force on the baby’s shoulders in a head-first delivery or tugging too hard at the baby’s legs in a breech (feet-first) birth. The source of this excessive force may be a pair of extraction forceps or a vacuum during a difficult delivery.

In fewer cases, a high maternal blood sugar level may also damage the brachial plexus of the fetus.

The recovery rate is usually 100% if caught and treated within the first month of life but is reduced to 80% if treatment is delayed.

2. Cerebral Palsy (CP)

Sometimes during delivery, the supply of oxygen to the baby is disrupted. It may be due to a detached placenta, a ruptured uterus, or a tied umbilical cord. This lack of oxygen delivery to the brain causes some brain cells to die, leading to a muscle and movement disorder called cerebral palsy. CP can also result from kernicterus caused by severe, untreated neonatal jaundice.

There is a higher incidence of CP in multiple and premature births before the 37th week of pregnancy.

As a result of CP, a child may display developmental delays, abnormal muscle tone, abnormal body posture, and lopsided crawling in the affected arm.

Unfortunately, there is no cure for CP but options are available to control its devastating effects. Discuss these with your physician at the earliest to ensure a better quality of life for your child.

3. Hypoxic Ischemic Encephalopathy (HIE)

Hypoxic ischemic encephalopathy occurs in newborns due to insufficient oxygen or blood flow to the brain. It implies an interruption in oxygen and blood supply to other organs during or before birth, including the heart, liver, intestines, and kidneys. 

The duration of this interruption is directly proportional to the amount and severity of damage caused. While other organs usually attain normal function again, the prognosis of the damage to the brain is poor.

4. Fractures

In cephalopelvic disproportion or breech birth, the shoulder tends to get stuck, a condition known as shoulder dystocia. As a result of greater than normal pulling force by the physician, a fracture of the clavicle might occur, which is the most common type of fracture due to a birth injury. Fractures also occur in the femur and humerus less commonly.

In cases where the fetus is in an abnormal position during birth, a cesarean delivery can prevent fractures.

5. Seizures

Some premature babies may exhibit internal bleeding in or around the brain. While most newborns do not show symptoms, others might appear lethargic or suffer from occasional seizures.

What Are The Possible Treatment Options?

As a parent, you want the best possible quality of life for your child. The wisest course of action is to consult a pediatrician to find ways to alleviate the symptoms. You need to invest your energy because your child needs special care and extra comfort.

The doctor might advise physical, emotional, occupational, speech, or recreational therapy to tackle the situation. A pattern and routine well-suited to your child’s needs can be more life-altering than you might think. It can help your child deal with shortcomings and manage a healthier daily routine while encouraging them to be independent and self-sufficient.

The doctor might also prescribe medications for pain relief, seizure control, muscle dysfunction, etc.

When a conservative approach is not enough, you might want to go down a surgical route with your primary physician’s consultation. Although aggressive, this option may help with issues in muscles, bones, and nerves.

Conclusion

Once an irreversible or partially reversible birth injury has occurred, it becomes a challenge for your child as well as for you. Sometimes, timely checkups and necessary precautions during pregnancy and birth are not enough, and the inevitable takes place. In such times, the one thing your child needs the most is to be able to depend on family and community. It might not be an easy battle for you or your child, but it is worth the effort.