Babies are born every day, but when doctors and nurses make mistakes or fail to take action when dangerous risks arise, the consequences can be devastating.
Although labor is a natural process, it places great stress on both mother and child. Complications occur, but when they are not appropriately addressed and managed, or when the delivery team fails to provide the necessary care and treatment, a resulting birth injury can be catastrophic for the baby and family.
Birth injuries during labor and delivery can result from reduced oxygen or blood flow to the baby, by trauma from improperly used instruments and equipment or from positional problems that go uncorrected or are handled inappropriately.
Reduced Oxygen or Oxygen Deprivation
An inadequate supply of oxygen to the baby during labor poses a significant risk for brain damage and death. Hypoxic-Ischemic Encephalopathy (HIE) occurs when the baby’s brain does not receive an adequate flow of oxygen, and can result in cerebral palsy, developmental problems, learning disabilities, impaired hearing, partial or total blindness, epilepsy and even death. This can also occur during pregnancy, but is particularly dangerous at the time of delivery.
Anoxia (oxygen deprivation) or hypoxia (reduced oxygen) can also result from:
- Premature separation of the placenta (placental abruption)
- Compression or entanglement of the umbilical cord, compromising the flow of blood and oxygen from the mother.
- The inability of the baby to breathe independently after birth, which can lead to serious brain damage or even death if not addressed shortly after the delivery.
- Contractions that are too strong, too frequent or too long, often from the improper use of Pitocin by the obstetrical team
The use of an electronic fetal monitor (EFM) to measure the baby’s heart rate and the contractions of the mother’s uterus allows doctors and nurses to see if the baby is experiencing signs of fetal distress, such as an abnormal heart rate or heart rate decelerations. Proper EFM interpretation lets doctors and nurses take immediate action to address signs of hypoxia and anoxia, but when fetal monitoring data strips (also referred to as FHR tracings) are misread or ignored, or when a medical professional hasn’t been adequately trained to read them, such errors can result in damage to the baby’s brain or death.
Statistics show that trauma caused by mechanical forces such as compression and traction during the birthing process happens in six to eight of every 1000 live births in the U.S., but nearly half are believed to be avoidable. Birth trauma takes different forms:
- Brachial plexus palsy or Erb’s Palsy can occur if the baby’s neck or shoulder is stretched too far during delivery due to abnormal or excessive traction.
- Vacuum extractors and forceps, when misused, can cause cerebral bleeds and contusions, facial nerve damage (Bell’s Palsy), damage to blood vessels and brain tissue, compression of the brain, skin lacerations, and skull fractures.
- Fractures of the clavicle or collarbone can occur when the doctor applies excessive traction, or subjects the baby to unnecessary force when a caesarian section delivery is the appropriate course of treatment.
- Prolonged labor can repeatedly compress the baby’s head and brain against the mother’s pelvis, and may cause infections or physical injury; this risk is heightened with larger infants.
Abnormal Fetal Position & Presentation
How the baby is situated during labor and delivery can also be a risk factor for birth injuries. Position refers to whether the fetus is facing up, down or sideways as it comes down the birth canal, and presentation refers to the part of the fetus’s body (head, foot, etc.) that leads in the birth canal. When the fetus is not in a normal position or presentation, complications can occur:
- Breech presentation indicates that the buttocks or feet are the leading part of the body, which creates a greater likelihood of injury than babies that present headfirst. During delivery, the passage of a normally positioned baby’s head creates a passageway in the birth canal large enough for the rest of the body. If a baby in a breech position isn’t reoriented before or during delivery, the narrower passageway may cause the head to become caught (posing a risk of birth trauma) and can cause compression of the umbilical cord (threatening oxygen flow from the mother).
- In a transverse presentation, the baby is oriented sideways, often causing the shoulder to lead, and jeopardizing passage through the womb. Similar to a breech presentation, if a transverse presentation cannot be corrected, delivery by caesarian section is usually the preferred approach.
Whether any of these issues played a role in your child’s injury can only be determined by a careful evaluation of all of the medical records. For more than 30 years, the lawyers at Sommers Schwartz have evaluated, litigated, and prevailed in complex birth injury cases, and stands ready to help you, too.