Erb's palsy is an injury to a baby's nerves which can occur during birth if the baby's neck is stretched or pulled during delivery. Medical studies show that one - two of every 1,000 babies is born with Erb' s Palsy.
Injuries from Erb's palsy originate in the brachial plexus. The brachial plexus is the is a network of nerves in the shoulder and arms that control movement. These nerves can be damaged during birth, resulting in temporary or permanent damage and loss of movement in one or both of the arms.
Erb's palsy is often the result of shoulder dystocia, when the baby's shoulder or shoulders get stuck or are too big to pass through the birth canal. Studies show that about 10% of babies with shoulder dystocia are born with Erb's palsy. According to the National Institute of Neurological Disorders and Stroke, a little over 95% of all Erb's palsy cases resolve themselves and result only in temporary injury.
Erb's palsy should be an avoidable injury. If your child has Erb's palsy as a result of negligence during birth, contact Gilman & Bedigian for a free consultation.
Causes of Erb's Palsy
Erb's palsy occurs during vaginal birth. Causes include:
- The use of delivery assisted tools, like forceps or vacuum-extractor tools, that unnaturally pull the baby's arms or neck
- The position of the baby's head during delivery, if the baby's neck is bent sideways and physician force is used, the birth could put too much pressure on its neck
- Pulling on the baby's shoulder during delivery
- Breech delivery when the baby comes out feet-first, this can put pressure on the baby's raised arms
Erb's palsy is most common in babies who are too big to pass through the birth canal. Though some injuries are inevitable during the physicality of birth, your doctor should monitor the size and position of the baby and be able to avoid facing the issues that lead to Erb's palsy.
Avoiding Erb's Palsy
There are many warning signs your doctor should be aware of to avoid birth injuries like Erb's palsy. These include:
- Failure to monitor the baby's size and weight (the baby may be too big to fit through the birth canal)
- Failure to elect to perform a C-section
- Failure to properly handle shoulder dystocia, when the baby's shoulders get caught on the mother's pubic bone
- Excessive force on the baby's neck, shoulders, or arms, often from pulling or twisting the baby, or using assisted delivery devices.
- Excessive use of lateral traction during a C-section
Your doctor should be able to recognize the signs of a potential birth injury, and make the necessary changes.
Erb's Palsy Injuries
There are four types of Erb's palsy. These are:
Neurapraxia- A “shock” to the nerves. This type usually resolves itself within a few months.
Neuroma- A stretch injury that results in scar tissue on the nerves. Scar tissue may affect the surrounding nerves. This may partly resolve on its own, but will not result in total recovery.
Rupture- A tearing of the nerve or nerves. This will not heal on its own and may require surgery.
Avulsion- The most severe injury, when a nerve is broken from the spinal cord. Not even surgery can result in total recovery.
A baby with Erb's palsy will show reduced or no movement in parts of their arm, their entire arm or arms, or in their hand or hands. The affected arm will typically be slightly bent and held against the body at an angle. The baby will have a decreased ability to grip in the affected hands.
The baby will also show an absence of the Moro reflex. This is tested by pulling the baby's arms up and letting go. The baby should spread its arms open and back up.
Most injuries should resolve themselves, or be treated by gentle massages of the affected area. Sometimes surgery will be required to help ameliorate or reduce nerve damage.
In most cases, the impairment of movement will only be temporary, and bruising and swelling will resolve itself within a few weeks or months. Doctors can relieve symptoms and restore movement ability through massage and physical therapy.
In the most serious cases, the results of Erb's palsy can be permanent nerve damage, loss of movement, weakness in the arm, pain, and muscle atrophy. Though surgery may be the only option in these cases, the medical community reports mixed results to the benefits of the surgery.
There are also other types of brachial plexus injuries that result in more serious and permanent injury to the baby.
The lawyers at Gilman & Bedigian have a reputation for success, and are dedicated to helping your family reclaim compensation for medical negligence during birth. Call Gilman & Bedigian today for a free consultation and to learn more about your options.