In any pregnancy, the parents' biggest concern is generally for the health and well-being of their child throughout the pregnancy and labor. However, even after the delivery of the child, there can be complications or medical errors that put the child at risk of harm. A newborn child needs proper care, including monitoring to make sure they are getting enough oxygen.
Birth injuries and complications can occur during pregnancy, during labor, upon delivery, or shortly after delivery. In some cases, there may be multiple birth complications occurring together. Failure to properly monitor and treat the mother and baby throughout the birth process and after delivery can increase the risk of a perinatal injury to the mother and the baby. If you have any questions about a neonatal birth injury, talk to an experienced medical malpractice attorney for help.
What is a Neonatal Injury?
A neonatal birth injury is a structural destruction or functional deterioration of the neonate's body due to a traumatic event at birth. After a traumatic delivery, the newborn may require specialized care and treatment to address any injuries, maintain oxygen levels to the baby's brain, and continued monitoring the baby.
Newborns can be very resilient and minor traumatic injuries may resolve on their own or with minor interventions. However, the baby's brain, spinal cord, and bones can be very sensitive to outside pressure and changes in oxygen level or blood supply. Some traumatic injuries or oxygen deprivation damage may be permanent.
Neonatal vs. Perinatal
The terms neonatal and perinatal may sometimes overlap and the terms can be confusing for parents understanding their child's health. In general, perinatal refers to the time around the birth. Perinatal relates to the time immediately before and after birth. Another term also used is “prenatal” which refers to the time leading up to and until birth. Neonatal refers to a newborn child, for the time period immediately after the child is born.
Common Types and Causes of Neonatal Injuries
There are a number of types and causes of neonatal injuries. These injuries can be categorized as head injuries, nerve injuries, and soft-tissue injuries. Some of the most dangerous injuries are those that limit blood or oxygen to the brain or damage the spinal cord. Spinal cord injuries, nerve injuries, and head injuries may cause permanent damage and require medical care and treatment for the rest of the child's life.
A traumatic birth can be caused by delivery complications and/or by medical negligence. Some common conditions that increase the risk of a traumatic birth include:
- Babies that weigh over 8 pounds 13 ounces (macrosomia)
- Baby's head or body is too large to fit through the mother's pelvis (cephalopelvic disproportion)
- Abnormal position and presentation (breech, face-first, or shoulder presentation)
- Babies born premature (before 37th week of pregnancy)
- Difficult childbirth (dystocia)
Macrosomia, cephalopelvic disproportion, or other problems with the size or shape of the baby or pelvic opening may cause the baby to become wedged in the birth canal. Forcing the baby out with the use of forceps or an extraction device may allow the baby to be delivered. However, it may also cause injury to the baby's head, neck, spinal cord, or result in broken bones or nerve damage.
An abnormal birth position or presentation can also complicate delivery. When the baby has an abnormal birth position, including breech birth or face-first, the baby may be repositioned to allow for a normal presentation. However, if the baby presents abnormally, it may make it difficult to reposition or deliver the baby without causing additional trauma.
Traumatic Head Injury
Too much force or pressure on the baby's head during delivery can cause bleeding or brain injury. Bleeding inside the skull may not be visible immediately after delivery but it carries a high risk of brain damage. Bleeding in the head can include:
- Cerebral hemorrhage (bleeding within the brain)
- Intracranial hemorrhage (bleeding inside the skull)
- Epidural hemorrhage (bleeding in the dura mater)
- Subdural hemorrhage (bleeding between the dura mater and the arachnoid membrane)
- Subarachnoid hemorrhage (bleeding in the space between the arachnoid membrane and the pia mater)
- Intraventricular hemorrhage (bleeding in the ventricular system, where the cerebrospinal fluid (CSF) circulates
Caput Succedaneum Scalp Swelling
Caput succedaneum is a type of swelling in the scalp caused by an accumulation of fluid between the outermost layers of the scalp and the subcutaneous tissue. This can appear as swelling in the scalp with a “conehead” type appearance. Caput succedaneum can cause more serious problems but it usually resolves on its own.
Cephalohematoma Head Lumps
Cephalohematoma is caused by damaged blood vessels under the skin of the scalp. This is generally caused by head trauma during labor and delivery. Cephalohematoma may appear as a soft bulge on the back of the baby's skull. In most cases, the bulges will begin to shrink and disappear on their own.
A subgaleal hemorrhage is caused by a rupture in the emissary veins between the dural sinuses and the scalp veins. This can cause blood to accumulate between the layers of the scalp. Subgaleal hemorrhage can lead to severe hypovolemia, putting the baby at risk of shock or brain injury. Up to a quarter of babies who require neonatal intensive care for subgaleal hemorrhage die from the condition.
Subconjunctival Hemorrhage Eye Injury
A subconjunctival hemorrhage is an eye injury that may be caused by a traumatic birth. The blood vessels in the eye can rupture, forming red patches across the eye. Subconjunctival hemorrhage is usually painless and may resolve within a few weeks. However, a subconjunctival hemorrhage may also be an indication that more serious trauma could have occurred during delivery, with internal damage that is not visible from the outside.
Nerve, Spinal Cord, and Bone Injuries
Improper delivery techniques or the use of extraction devices can injure the soft tissue, nerves, spinal cord, and cause bone fractures.
Shoulder dystocia is a birth injury that occurs when one or both of the baby's shoulders become wedged by the mother's pelvic bone, preventing the baby from passing below. Maneuvers can help reduce the likelihood of injury by repositioning the child. However, improper delivery or treatment of a child with shoulder dystocia can cause palsy, clavicle fracture, permanent nerve damage, or fetal death.
Spinal Cord Injury
A spinal cord injury can occur in a number of ways during delivery including:
- Using too much force to deliver a child from the birth canal;
- Twisting or over-extending the spine during delivery; or
- Using forceps or a vacuum-extraction tool that injures the spinal cord.
Avoiding Neonatal Birth Injuries
Many neonatal birth injuries are caused by trauma during delivery. In a difficult labor where the child is larger than normal or has a problem with presentation, it may be difficult to deliver a child safely without putting both the mother and baby at risk of traumatic injury. The only way to avoid injuries may be through cesarean delivery (C-section).
Unfortunately, some doctors wait too long before deciding to do an emergency C-section. Any delay in delivery after a child begins to suffer fetal distress can increase the risk of oxygen deprivation and brain injury. If a child suffered brain damage because of delayed C-section delivery or because of a failure to properly monitor the baby, the family may be able to file a malpractice claim to recover damages to pay for medical care. A malpractice lawsuit may also help other families avoid similar tragic events in the future.
Medical Malpractice and Neonatal Injury
Traumatic birth injuries and neonatal injuries can also be caused by medical errors. In a difficult labor, a doctor may have a number of options, including an emergency C-section if the baby is in fetal distress, there is a risk of oxygen deprivation, or vaginal birth would likely cause serious injury. If a doctor continues to attempt vaginal delivery when the standard of care would be to do a C-section, the doctor may be putting the baby and mother at risk of injury.
Alternatively, trying to speed up delivery with improper treatment or unnecessary C-section can also cause injury to the baby or mother. Some doctors are in a hurry to get through the delivery process and will try and speed things along, even if everything is progressing at a safe speed. A prolonged labor may be overdiagnosed as a way for the doctor to justify unnecessary interventions or to do an emergency C-section because it works better for the doctor's schedule even if it is not better for the baby and mother.
Another common malpractice cause of neonatal injury involves the failure to properly monitor the baby and mother. When a pregnant woman is in labor, she relies on doctors and the medical staff to monitor her vital signs and the vital signs of the baby. She also relies on the doctors to know what to look for when things go wrong. If the baby and mother's vital signs show something is going wrong or something needs to be done, failure to take action may cause injury to the baby and mother.
Neonatal Injury Medical Malpractice Lawyers
If your child was injured because of medical negligence, talk to an experienced birth injury attorney about your options for recovery. Doctors and hospitals should be held accountable for their actions. Do not hesitate to contact Gilman & Bedigian today for a free consultation.