Birth is a traumatic experience for any
baby and most birth injuries are minor, such as swelling, bruising
or minor bleeding. Yet for 27 out of every 1,000 babies born,
severe birth injuries occur. These severe birth injuries may involve
hemorrhage, paralysis, broken bones and other serious injuries.
Contributing factors to the birth injuries
include high birth weight (over 9 lbs), the shape of the mother's
pelvis and size of vaginal opening, a breech birth (feet first)
or an abnormally long or short labor.
While each of these situations can contribute to a birth injury,
there are steps that every doctor can take to prevent most injuries
from occurring. Failure to diagnose, take preventative measures
or respond to injury-causing events can result in birth injuries
where doctors can be held liable.
Some of the more common severe birth injuries include brain
injury, spinal cord trauma,
cerebral palsy, spastic, athetoid and ataxic cerebral palsy, Klumpke
and Erb's palsey, Group-B Strep, Horner syndrome and shoulder
Brain injury can occur if
the baby is deprived of oxygen because of twisting or compression
of the umbilical cord or from blood loss. This type of brain injury
typically results in cerebral palsy, seizure disorders or other
Spinal cord trauma and injury
during birth can be caused by excessive traction or rotation of
the infant. For breech deliveries the cervical and upper thoracic
region account for most injuries. For vertex deliveries the upper
and mid-cervical region account for most spinal cord injuries.
Spinal cord trauma may account for stillbirth or for rapid neonatal
death of the infant. Infants that do survive may experience neuromuscular
disorder and spasticity that may be mistaken for cerebral palsy.
Spastic cerebral palsy is
the most common form of cerebral palsy. It accounts for approximately
70-percent of the cases and is characterized by contracted muscles
that are in constant involuntary reflex and sometimes paralysis.
Athetoid palsy affects 10
to 20-percent of the cerebral palsy patients. It is characterized
by slow and uncontrolled involuntary movement of the hands, feet,
arms and legs. Some patients also experience speech problems and
drooling as the result of partial face paralysis.
Ataxic palsy is the rarest
form of cerebral palsy affecting just 5 to 10 percent of the patients.
It is characterized by lack of coordination, balance and depth
perception. Patients may have a hard time using fine motor skills
and dexterity to write or tie objects.
Klumpke palsy is a birth
injury due to traction on the arm in the abducted position during
birth. It involves damage to the eight cervical and first thoracic
roots or the lower portion of the brachial plexus nerve group.
Klumpke palsy is characterized by paralysis of the muscles in
the hand and forearm.
Erb's palsy is a birth injury
involving the brachial plexus nerve group. This group of nerves
is responsible for movement of the hand, arm and shoulders. Erb's
palsy can cause a gradual loss of movement in these body parts
and in same cases paralysis.
Group-B Strep is short for
Group B Streptococcal Disease. Group-B Strep is a life-threatening
bacterial infection in newborns. Pregnant women can transmit Group-B
Strep to their newborns but the disease can be prevented in babies
by giving the mother's antibiotics during labor.
Horner's syndrome can be
caused by a neck trauma during birth or from an injury to the
brachial plexus nerve group. Horner's syndrome is characterized
by an abnormally small pupil and droopy eyelid in the infant and
is an indication of damage to the sympathetic nerves of the face.
Shoulder dystocia occurs
during difficult births with large babies when the infant's head
is delivered but the shoulders are stuck behind the mother's pubic
bone or in the birth canal. Shoulder dystocia injuries may go
away with time or they may be permanent resulting in paralysis
of the arm. Other injuries include a broken arm or collarbone.
Doctors can prepare themselves ahead of time for the possibility
of shoulder dystocia with an ultrasound of the mother before labor.
A C-section can be performed to alleviate this potential problem.
If the situation happens without warning, certain procedures such
as the McRoberts maneuver can be performed to avoid complications.
While many birth injuries heal with time or additional medical
treatment, many others will last a lifetime. Besides the emotional
implications, parents may be burdened with years of medical bills
because of the birth injuries. If a parent suspects a birth injury
is due to medical malpractice it is wise to seek representation
as soon as possible so that documentation may be accumulated and
the facts of what happened can be sorted out. For additional information,
see the page on birth injury