Babies are fragile creatures, especially in those first, tender days. Unfortunately, sometimes parents take their precious newborn home only to later discover their baby is displaying symptoms of a birth injury. This terrifying discovery can lead to a rash of questions, including whether the doctor, hospital, or nurses are to blame, how life raising a child injured at birth will be, and what treatments are available.
The following guide will attempt to answer many basic questions and point towards further information that can be learned in consultation with a medical professional. Nothing in this guide should be construed as legal advice—this is simply a general-purpose guide concerning birth injuries from our Tulsa birth injury attorneys.
“Hypoxia” refers to a lack of oxygen. The term “intrauterine hypoxia” refers to an extremely serious condition where a baby is denied sufficient oxygen for a period of time.
Intrauterine growth restriction, commonly referred to as IUGR, refers to a situation in which the fetus fails to thrive during pregnancy, a condition that can be caused by an inadequate oxygen supply to the fetus. IUGR is a key factor responsible for more than half of low birth weight neonatal deaths around the world, as well as surviving premature and low birth weight babies.
Birth asphyxia is a special term that refers to hypoxia occurring during the delivery process. Also called perinatal asphyxia, this condition can be caused by several factors, such as the baby getting caught in the umbilical cord and other complications during childbirth.
In the United States, intrauterine hypoxia and birth asphyxia combined are together ranked as the tenth leading cause of neonatal deaths.
BRACHIAL PLEXUS INJURIES (BPI)
A brachial plexus injury generally refers to injuries sustained in a particularly important bundle of nerves on the spinal cord. These special nerves run across the spine and allow people to control the muscles in their chest, shoulders, arms, and hands. When these nerves are injured, such as during childbirth, they can form a lesion that may cause partial or complete paralysis.
BPI is often caused by excessive stretching of the spine during delivery. During some difficult deliveries, the baby’s shoulder can become blocked in the birth canal after the head has already passed through, referred to in medical terms as “shoulder dystocia.”
It may be difficult to detect signs of BPI immediately after birth. Symptoms include paralyzed or “floppy” arms, no flexing or control of the hand, no turning or manipulation of the wrist, an inability to move the arm, and numbness. BPI can lead to impairment to the arm, hand, or wrist while simultaneously causing a great deal of pain for the baby; in worse cases, it can lead to total and irreversible paralysis, currently untreatable by modern medicine.
The good news is that many babies can completely or partially heal within six months. Unfortunately, babies who show no marked improvement in that time may require surgery to repair their nerve damage.
Erb’s Palsy, sometimes called Erb-Duchenne Palsy, occurs when a specific group of nerves on the spine are injured and thus cause partial or complete paralysis to the arm. The group of nerves responsible for controlling the arm are a subset of the brachial plexus, meaning that Erb’s Palsy is a subset of other BPI.
Erb’s Palsy is almost always caused by shoulder dystocia—extracting a child whose head is out but shoulders are not—during a difficult birth. Erb’s Palsy can also be caused by excessively hard pulling on the arms during a breech birth (when the feet exit the birth canal first during delivery).
Depending on the severity of the damage to the nerves, some babies can see the paralysis resolve itself over a period of months without any rehabilitative therapy or surgery necessary. Other babies will see paralysis of the arm lead to atrophy of the muscles and a loss of ability to bend the elbow. Sometimes, physical therapy including massage and the application of electrical current to the muscles can reverse atrophy and help strengthen muscles in the arm.
It should be noted that many babies and young children with Erb’s Palsy suffer a great deal of pain and discomfort; fortunately, a variety of surgical techniques now exist to help provide relief from Erb’s Palsy.
Much like Erb’s Palsy, Klumpke’s Paralysis refers to a subset of the nerves in the brachial plexus. Because these two conditions are so similar, sometimes Klumpke’s Paralysis is referred to as Klumpke’s Palsy. Klumpke’s refers to nerves that originate in the back of the neck and control muscles of the hand and forearm. Unfortunately, because the back of the neck is such a fragile area, damage to the cluster of nerves is often much more extensive, leading to lifelong paralysis.
Klumpke’s is almost always the result of complications during the delivery process, especially when the infant is very large and/or the mother is very small. Many babies who are too large to easily exit the birth canal get one arm stuck, and when they are pulled out during the delivery process, it “yanks” the delicate bones and thus causes nerve damage.
Cerebral palsy, often shortened to CP, is a group of different nerve disorders that first start manifesting in early childhood. Many babies born with CP have difficulty performing normal physical activities like sitting up, crawling, rolling over, or walking.
Young children who have trouble coordinating their muscles and show symptoms including shaking, trembling, difficulty swallowing, and poor coordination may be suffering from CP. It is often only when the baby reaches six to nine months of age that muscle control issues and shaking may be first identified. CP can then degenerate into seizures, epilepsy, urinary and fecal incontinence, intellectual disabilities, and behavioral problems.
As CP expresses itself on a sliding scale of magnitude, there are different therapies and treatments available to help young children survive CP into adulthood. As breakthroughs are always on the horizon for preventing and curing this persistent neonatal injury, it is best to consult with a doctor or medical expert if you believe your child may be exhibiting symptoms of cerebral palsy.
The delivery process can easily expose a baby to dozens of powerful infectious microscopic agents. As newborns have weak and undeveloped immune systems, they are often particularly vulnerable to infection. Powerful viruses such as HIV, rubella, syphilis, herpes simplex, CMV, and hepatitis B can be particularly devastating to newborn babies. Harmful bacteria can also attack the vulnerable immune system of babies, including E-Coli, listeria, gonococci, and even chlamydia.
Babies can become vulnerable to infections in one of three ways: from their mother and transmitted via the placenta, exposure to infectious agents during delivery, or from coming into contact with external sources after birth.
Whether from the tension, torque, or traction of the birthing process, it is possible for babies to sustain bone injuries. The most common bone fracture during delivery is the clavicle; however, any other bone can potentially be broken or bruised during a traumatic delivery.
THE DIFFERENCE BETWEEN BIRTH INJURY & BIRTH TRAUMA
Doctors and medical experts have been studying birth injuries since the beginnings of modern medicine. To be extremely precise, birth injuries are any systemic injury incurred during the delivery process, while birth trauma refers to what is objectively referred to as mechanical damage to the baby.
To put it in simpler terms, birth trauma is when a physical force, usually from a medical instrument, is applied during the delivery process and damages a child. Birth injuries are more “natural” injuries when the baby is injured during some form of maladjustment during the delivery process. Together, these and other injuries are referred to as birth injuries while applied force injuries, usually from medical instruments, are classified as birth trauma.
Do you have questions about birth injuries? Or has your child been injured by a medical professional and you are considering taking legal action? We’re here to help. Contact our Tulsa birth injury attorneys online to schedule your free case evaluation.