Injuries During Delivery

Many thousands of babies are born in the United States each year. Most of these deliveries are uncomplicated and lead to healthy babies and new mothers. However, complications can and do occur during the birthing process. Knowing the different types of birth injuries and how they occur can help parents take actions to prevent such actions from occurring in the first place.

What are Some of the Most Common Birth Injuries?

Having a baby is not without risk. Though medical interventions have vastly improved in recent years, the potential for injury still exists. Some of the most common birth injuries include:

Brachial Plexus Injury

Brachial plexus injuries, or Erb's Palsy, involve nerve damage to the shoulder or arm. The brachial plexus is a delicate bundle of nerves that controls the motion of the upper arm. A traumatic delivery can damage these nerves, which can cause long-lasting or permanent damage. In some cases, the nerve damage will be permanent unless the child receives timely surgical intervention.

Brachial plexus injuries can range from stretching to a complete avulsion (separation from the spinal cord). Unfortunately, sometimes the injury is not apparent until a child is a few months old. Parents may notice limpness or paralysis of the affected area. To make a full recovery, some children may require surgery or physical therapy to improve tone and function. For others, the damage will be permanent.

Uterine Rupture

A uterine rupture is a rare, but life-threatening, possible occurrence during delivery. This happens when the tissue of the uterus tears. It may be partial or complete. A complete uterine rupture can send the baby into the abdominal cavity, where it is in danger of suffocation.

Uterine ruptures are most common in women who have had previous uterine surgeries such as cesarean section. Women who wish to attempt a vaginal delivery after C-section (VBAC) require careful monitoring during labor.

Cerebral Palsy

Cerebral palsy is a neurological condition that may occur as the result of a traumatic birth. Any oxygen deprivation or fetal distress during labor can lead to neurological damage, which can lead to an eventual diagnosis of cerebral palsy. The symptoms of cerebral palsy usually present within the first few months of a child’s life and may include:

  • Muscles that are exceptionally stiff (hypertonia) or floppy (hypotonia)
  • Muscle spasticity
  • Delays in achieving gross motor milestones such as rolling over or sitting up

As babies become toddlers, other symptoms may become apparent and include delays in walking or an abnormal gait. Children may also experience delays in using or understanding speech, cognitive impairment, and more.

Facial Paralysis

A traumatic birth can also damage the nerves of the face, a condition called Infant Bell’s Palsy. Possible causes include forceful use of birth assistive tools such as forceps or a baby that is large for gestational age.

Identifying Risk Factors for Birth Injury

Providers can help prevent the occurrence of birth-related injuries by recognizing the risk factors and taking steps to prevent them. In some cases, this may be scheduling delivery via a cesarean section, particularly if a baby is very large or a mother's uterine muscles are particularly weak. In other cases, preventive factors may involve patient counseling or increased imaging and monitoring of the developing fetus.

Both health care providers and patients play an important role in preventing the occurrence of birth injuries in children. By identifying possible risk factors and providing timely medical intervention when necessary, providers can improve health outcomes for both mother and baby. Failure to intervene when a mother or a baby has a potentially dangerous medical condition could have severe and lifelong consequences.

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