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Birth injuries include cerebral palsy, Erb’s palsy, and complications of brain and nerve damage. Causes may include doctor mistakes, like failure to perform a Cesarean section or improper use of delivery instruments. Other causes include illness in the mother or a condition in the baby at the time of birth that goes undiagnosed and untreated.
Cerebral palsy is one of the most common consequences of a birth injury, and it is most commonly caused by asphyxia during childbirth. This means that the baby has lost oxygen for a period or that the blood flow to the baby is low in oxygen.
Oxygen loss can be caused by a complication during delivery, such as blood being cut off from the umbilical cord or a problem with the placenta.
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Loss of oxygen or limited oxygen to the brain of a newborn causes brain cells to die, leading to brain damage. The brain damage may be severe enough to cause cerebral palsy, leading to associated disorders of CP, including cognitive impairments, vision and hearing problems, delayed speech, and learning disabilities.
In many cases, the asphyxia that causes cerebral palsy was preventable and may be attributed to medical malpractice.
Brain damage is not only caused by asphyxia and does not only lead to cerebral palsy. A baby may be born with brain damage caused by a skull fracture, infection in the mother, preeclampsia in the mother, or conditions in the baby that are left untreated, like jaundice.
Asphyxia is the most common cause of all types of brain damage in newborns, but these other causes may also result in serious brain damage.
Erb’s Palsy and Brachial Plexus Injury
Injury to nerves is another common kind of birth injury. The brachial plexus nerves, which run from the spinal cord to the shoulder and arm, control movement in the arms and provide sensation in the arms.
The leading underlying cause of this kind of birth injury is overstretching of the baby’s arm, shoulder, neck, or head. The nerves run down the neck to the arm, so if a doctor or midwife pulls on a baby’s arm while its head is still in the birth canal, this can stretch and damage the nerves.
Babies that are unusually large, in the breech position, or born during long and difficult labor are at the greatest risk for this type of injury.
Other Nerve Injuries
The brachial plexus is the set of nerves most commonly injured in a baby during birth, but others can be damaged as well.
The cranial nerves are the next most likely types of nerves to be damaged. These are the nerves that start in the brain stem instead of the spinal cord.
These nerves are most likely to be damaged by forceps or pressure applied as the baby comes through the birth canal. The result of damage to the cranial nerves may be facial paralysis or loss of sensation and asymmetrical movements in the face.
Labor and delivery put tremendous pressure on the head of a newborn. A baby’s skull is flexible and not fully hardened at birth so that it can squeeze through the birth canal.
However, the skull is still vulnerable to injury and may fracture during birth. Injury can vary from serious to not being readily apparent.
Birth injury causes for skull fractures are most commonly connected to instruments. A doctor may use a vacuum extractor or forceps to help deliver the baby during difficult labor. These instruments, used with too much force, can physically damage or fracture the skull.
It is also possible that a skull fracture will simply result from pressure put on the baby’s head by the mother’s pelvis and birth canal.
The most tragic of all birth injuries are those that lead to the death of an infant. There are many potential causes of this type of death. Severe asphyxia is difficult to reverse, and an infant may not survive.
Death can also result from severe damage caused to the skull and brain by the use of instruments like forceps. Untreated severe jaundice, preeclampsia that turns into eclampsia, and other illnesses can also lead to infant death.
When the death of an infant is found to have been preventable, if the caregiver made an error in judgment, or failed to take necessary action, the death may be ruled to have been caused by medical malpractice. Many parents choose to file a lawsuit to seek compensation and money to cover the associated costs.
- Dupuis O , et al. (n.d.). Comparison of "instrument-associated" and "spontaneous" Obstetric Depressed Skull Fractures in a Cohort of 68 Neonates. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/15672020
- Causes and Risk Factors of Cerebral Palsy. (2019, September 23). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/ncbddd/cp/causes.html
- Birth Injuries in Newborns. (n.d.). Merck Manuals Consumer Version.
Retrieved from: https://www.merckmanuals.com/home/children-s-health-issues/problems-in-newborns/birth-injury
- Erb’s Palsy – Who is to Blame and What Will Happen? (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724163/
- Oh CK and Yoon SH. (n.d.). The Significance of Incomplete Skull Fracture in the Birth Injury. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20005051