Unfortunately, birth injuries to infants and their mothers are not uncommon. Some birth injuries are caused by the natural processes of pregnancy and childbirth and are unavoidable even with appropriate medical care. Other birth injuries, however, may be caused by medical malpractice.
After a birth injury, parents want to know why their child suffered an injury. Experienced medical malpractice attorneys, like those at Morris James LLP, who handle birth injuries cases, can investigate the case and help you to find out what happened and whether or not the injury could have been avoided.
In this article, we look at some of the causes of birth injuries to a baby. We recently discussed the causes of birth injuries to a mother here. If you need more information about birth injuries to a baby or a mother, our birth injury attorneys at Morris James are available to help. Contact us online or call us at 302.655.2599.
How do birth injuries to a baby happen?
There are many causes of birth injuries, some of which are preventable, and some of which are not. Some birth injuries may be due to mismanagement of the pregnancy, while others may be due to mismanagement during the labor and delivery. To prevent an avoidable birth injury, healthcare providers need to be aware of the mother’s and baby’s risk factors for developing complications, and must act appropriately.
When there are complications or difficulties in pregnancy or childbirth, birth injuries are more likely to happen. However, they can also occur in seemingly straightforward deliveries. Sadly, an initial birth injury can lead to other injuries and complications, and it is common for some of the below issues to overlap. Having an attorney with the knowledge of these issues and with connections to qualified medical experts can help you learn the causes of your or your child’s injuries.
Improper handling of difficult or high risk conditions
Certain conditions in a mother or baby can increase the risk of injuries during childbirth. For example, a very large baby (called fetal macrosomia) or small-proportioned mother (cephalopelvic disproportion) can lead to problems during delivery. A baby in a breech position or stuck on the mother’s pubic bone (shoulder dystocia) can likewise cause birth injuries. In both situations (and others,) the infant can become stuck in the birth canal, increasing the risk of oxygen deprivation (discussed further below,) and injury to bones, soft tissues, and nerves from forced extraction techniques used to expedite the delivery.
With proper monitoring and care, healthcare providers can reduce or eliminate these risks. Specifically, in certain cases, the medical provider should identify the risk of a difficult delivery or specific injury to the mother or baby, discuss it with the mother, and potentially plan an early induction, scheduled C-section delivery, or other medically-indicated intervention.
Even if the problem could not have been prevented by prenatal screening, properly-made and enacted decisions during the labor and delivery can reduce the risk of injury to the baby in certain situations. For example, depending on how the baby is doing, the medical team may need to switch to an emergency C-section or (properly) use vacuum extraction or forceps. Sometimes, the baby will need to be physically manipulated by the doctor. A delivery team needs to act quickly and cautiously to avoid any delays or missteps that could injure the baby. If they do not, they may be responsible, morally and legally, for any birth injuries that occur.
Failure to monitor before, during, and after childbirth
Inadequate prenatal, delivery, and post-natal monitoring can also result in injuries to a newborn baby. During pregnancy, a mother and baby are monitored for developmental problems, infection, and other issues. In the delivery room, they are monitored for abnormal vital signs, agitation, exhaustion, dehydration, and other concerns. The baby’s heart rate, including their heart’s response to the mother’s contractions, is also monitored to assess whether the baby has sufficient oxygenation to tolerate labor and delivery. After delivery, the mother and baby should be monitored closely, including for high blood pressure, development problems, mental health concerns, and infection. This monitoring can help detect risks of the baby developing problems post-delivery.
If healthcare providers do not monitor the mother and baby properly, they may fail to recognize risks of injury and in turn not take the proper steps to avoid injury to the baby. For example, if a delivery team does not recognize that a baby’s oxygen’s levels or heart rate are dropping during delivery, and if they fail to take the appropriate action to deliver the baby quickly, the baby can be left with brain damage or other permanent injuries. Likewise, if a healthcare provider does not test an expectant mother for Group B streptococcus before childbirth and in the case of a positive test, administer the simple treatment needed to cure the infection, her baby could suffer serious neurologic damage. While there are other examples of a healthcare provider’s failure to appropriately monitor and treat a mother and her baby, any failure can cause a birth injury and serve as the basis for a medical malpractice claim.
Oxygen deprivation is one of the most common causes of birth injuries, and it overlaps with other issues discussed above. A baby may be deprived of oxygen if it is stuck in the birth canal, or when the mother’s contractions are too frequent and/or too strong. Oxygen deprivation typically happens as a result of a difficult or prolonged labor or other complications, such as umbilical cord problems.
When a baby is deprived of oxygen, it can lead to catastrophic brain injuries, including cerebral palsy and hypoxic ischemic encephalopathy (HIE). Babies with brain injuries can suffer motor difficulties; development delays; vision, hearing, and speech problems; respiratory issues; seizures; cognitive impairment; and reduced life expectancy, among other problems. Many of these problems are, unfortunately, permanent and can lead to life-long financial and emotional hardship for the child and parents. In some situations, these injuries could have been avoided or reduced by timely medical intervention by the delivery team during childbirth, or by prompt diagnosis and treatment after birth. An experienced attorney can evaluate a case with appropriate experts and determine whether these injuries resulted from a healthcare provider’s medical malpractice.
Force or trauma
In a difficult delivery, it is sometimes medically appropriate to physically manipulate the baby in the birth canal, or use vacuum extraction or forceps to assist with the delivery. It is important, however, for these methods to be used appropriately and safely. Even where interventions are necessary to safely deliver a baby, they must be carried out within the appropriate standard of care. If they are not, the medical professional can cause significant injury to the baby, all of which was preventable. Common birth injuries from these forceful techniques include bone fractures (such as a fractured clavicle in a breech delivery); nerve damage (such as facial paralysis from forceps or brachial plexus injury from rough manipulation;) bruising; hematomas; and brain injuries. If a healthcare provider uses these techniques improperly, causing injury to the newborn baby, the medical professionals can be held liable for the harm that they have caused.
When a child is delivered by C-section, or other surgical procedures are used during labor and delivery (such as an episiotomy), there are additional risks to the child and mother. Some common birth injuries suffered by a baby as a result of a surgical error are lacerations and nerve damage, where a scalpel, clamp, or other surgical tool slash the soft tissue or nerves of the newborn child. On top of the obvious harm of the wound and possible physical disfiguration, such an injury can lead to further problems for the child, including physical, cognitive, and developmental issues; permanent physical deformities; additional surgeries to repair the damage; and infection from the wounds.
If a newborn baby has been injured by surgical error, it should be accounted for and explained to the child’s parents or guardians. Some surgical injuries happen even where the physician is operating with the appropriate care, but this should not be assumed. The child and his or her family should know and understand how the injury happened, whether or not it could have been avoided, and how they can help their baby’s healing.
Improper use of medications
Medication given to a mother or child, either for reasons related to pregnancy and childbirth or otherwise, may be necessary but can also be harmful to an unborn or newborn baby. Pharmaceuticals given to the mother during pregnancy could lead to developmental problems, brain damage, or even stillbirth. Medications given to induce labor, such as pitocin, should only be used in appropriate situations, and they must be dosed and administered correctly, and require close monitoring of the mother and baby. If these labor-inducing drugs are incorrectly used, they can increase the risk of uterine rupture, fetal distress, and oxygen deprivation for the baby, all of which can lead to significant injuries. Anesthesia, while often necessary in many births, can also carry risks for the baby, such as when an epidural needle is inserted in the wrong place.
Parents rely on their healthcare providers to prescribe and administer medication that will help, not harm, them and their baby. When a baby is injured by drugs used in pregnancy or childbirth, the parents deserve answers about what happened and how their healthcare team may have failed them and hurt their baby.
Infection in a newborn child can come from a variety of sources and cause many different issues for the child. Sometimes infections (such as Group B strep or toxoplasmosis) are transferred from the mother to the baby during pregnancy or delivery, which may have been avoided by proper prenatal monitoring and treatment. Infections can also arise from non-sterile conditions in the delivery room and surgical wounds, many of which are often very treatable in adult patients but catastrophic in a newborn. Infections in a baby can lead to early onset sepsis, pneumonia, respiratory issues, hearing and vision problems, and brain injuries like meningitis or cerebral palsy. Infants who are weakened by other injuries at birth are also at higher risk of infection and severe injury as their tiny bodies fight against multiple problems.
A mother’s and baby’s healthcare team should take every reasonable action to reduce the risk of infection in a baby, and to diagnose and treat that infection promptly and properly. If they do not, they may be guilty of medical malpractice and can be held responsible for the resulting injuries caused to the baby.