The last thing any pregnant mother-to-be wants to think about is a birth injury. Unfortunately, birth injuries and birth defects are a reality of modern U.S. medical care. Birth injuries can involve unpreventable birth complications. However, other birth injuries are entirely preventable. When a birth injury is caused by medical negligence, the doctor responsible should be held accountable.
Doctors, nurses, and hospitals all make mistakes. When those mistakes lead to serious injury in a newborn or mother, the patients can recover damages for their losses. Medical malpractice damages help pay for the costs of treatment and care for the baby and family. A lawsuit can also reduce the risk of future injuries for others by holding the medical industry accountable.
If you are concerned about the care you received in the hospital when pregnant or during or after delivery, find out about your rights. Talk to an experienced medical malpractice lawyer to understand your legal options for recovery.
Common Types of Birth Injuries
There are many types of birth injuries, including problems that happen when the fetus is developing, before delivery, during delivery, or in a perinatal setting. Injuries can involve chemical imbalance, health conditions in the mother, traumatic injuries, or failure to properly care for the child after birth.
According to the Children’s Hospital of Philadelphia (CHOP), some of the more common birth injuries are:
- Caput succedaneum
- Cephalohematoma
- Bruising and forceps marks
- Subconjunctival hemorrhage
- Facial paralysis
- Brachial plexus palsy
- Fractures
Some of these neonatal injuries are not permanent and will heal over time. However, they may indicate more serious problems in the way the doctor handled the delivery.
Caput Succedaneum and Brain Swelling
Caput succedaneum is swelling in the soft tissue of the scalp. This can be caused by tension and pressure when the child’s head travels through the birth canal. This can appear as swelling or bruising. In minor cases, it can resolve within a few days. However, other types of skull and brain swelling can be more serious.
Brain hemorrhage involves bleeding inside the skull. The space in the skull is taken up mostly by the brain and protective barriers. When there is bleeding inside the skull it can cause swelling or edema. Cerebral edema can put pressure on the brain, damaging sensitive brain tissue. If not resolved it can kill brain cells and cause permanent brain damage.
Types of swelling from hemorrhage in the brain are based on where the bleeding occurs, including:
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage
- Intracerebral hemorrhage
- Intraventricular hemorrhage
In newborns, intraventricular hemorrhage (IVH) involves bleeding into the ventricles in the brain. This can happen within a few days after birth. Grades 1 and 2 usually involve small amounts of blood. In Grade 3 IVH, the bleeding is significant enough to press on brain tissue. Grade 4 IVH directly involves brain tissue and can result in blood clots blocking cerebrospinal fluid from flowing, increasing the risk of hydrocephalus. This condition is more common in babies that are born prematurely.
There are several reasons why a baby could be born prematurely. According to the National Institutes of Health (NIH), certain medical conditions and other factors could place pregnant women at higher risk for preterm delivery, including:
- Women under the age of 18
- Women older than age 35
- Smoking
- Drinking alcohol
- Drug use
- Domestic violence
- Stress
- Blood clotting problems
- Diabetes and gestational diabetes
- Placenta previa
- Short time between pregnancies
- Underweight or obese
- High blood pressure
- Urinary tract infections (UTIs)
- Sexually transmitted infections (STIs)
Some of these conditions can be addressed to lower the chance of premature delivery. However, if a doctor negligently does not diagnose or fails to treat certain medical conditions, the doctor could increase the risk of a premature delivery. The mother and baby could have a medical malpractice claim against a doctor for failing to diagnose preterm labor or failing to properly treat the patient.
Cephalohematoma and Head Injuries
Cephalohematoma is bleeding under the fibrous membrane covering the skull. This can occur with head trauma during delivery. This often appears at the rear of the baby’s skull and can develop within a few hours after delivery. In minor cases, the body will reabsorb the blood and the baby will be fine. However, if there is more serious bleeding, it can take the body time to break down the red blood cells, increasing the risk of jaundice.
Jaundice can be identified by the yellowing of the baby’s skin and eyes. Jaundice itself is not uncommon in newborns and can often resolve without major problems. However, jaundice can indicate liver problems and lead to more serious health complications like kernicterus.
Jaundice involves an imbalance of red blood cells. This leads to too much bilirubin in the blood. The bilirubin is broken down by the liver. In a newborn, the liver may not be able to process too much bilirubin, which can build up in the gray matter of the central nervous system. This can cause organ damage, including liver problems. If hyperbilirubinemia is not resolved, it can increase the risk of cerebral palsy, brain damage, and hearing damage.
Bleeding and bruising in the skull can occur during negligent delivery. If the doctor uses improper delivery techniques, including improper use of forceps or too much force, it can cause serious injuries to the child, including bruising, head and neck injuries, or cause other serious health conditions.
Bruising and Vacuum Extraction
During a difficult delivery, some doctors turn to assistive devices to help the baby come through the birth canal. Causes of some delivery complications can include:
- Cephalopelvic disproportion (the baby’s head or body is too large for the mother’s pelvis)
- Macrosomia (baby larger than average)
- Abnormal birth positions
- Uterine rupture
Forceps are like large tongs that grip the baby’s skull trying to pull the baby through the birth canal by force. A vacuum extractor is an assisted delivery device that applies suction to the baby’s head to pull the baby through. In modern medicine, vacuum extraction is only recommended under certain conditions. Other options include a c-section to immediately deliver the baby.
Unfortunately, some doctors do not always follow medical standards of care. If a doctor deviates from accepted medical standards and causes an injury, it can be considered medical malpractice.
In some cases, it is medically recommended to allow for vacuum extraction, including maternal exhaustion or a non-reassuring fetal heart rate. However, there are times when vacuum extraction or ventouse is not recommended, such as when a fetus is under a certain age, size, or weight.
Doctors who use vacuum extractors should have proper medical training and experience before performing a vacuum-assisted delivery. Negligent vacuum extraction can cause serious injuries to the baby, including:
- Head bruising
- Bleeding in the skull
- Neck injuries
- Brain injuries
- Vaginal lacerations
- Scalp lacerations
- Intracranial hemorrhage
- Retinal hemorrhage
- Hyperbilirubinemia
- Neurological injuries
Subconjunctival Hemorrhage and Facial Injuries
A subconjunctival hemorrhage is bleeding in the eye. The newborn can have burst blood vessels between the eye and covering conjunctiva. This can occur when pressure is exerted on the baby during delivery. The eye can become red as blood forms in patches, showing internal bleeding in the eyes.
In most cases, bleeding in the eyes is minor and will resolve on its own. However, it can indicate difficulties with the delivery and the level of force used to deliver the baby.
Facial Paralysis and Forceps Injuries
Facial paralysis can be disturbing for new parents. Too much pressure on the baby’s face during delivery can cause damage to the facial nerves. Facial paralysis can involve damage to the seventh cranial nerve or facial nerve. Facial nerve palsy can cause involuntary movement in the baby’s face caused by traumatic injuries to the facial nerves.
The risks of facial paralysis or facial nerve palsy can increase when delivery instruments like forceps are used to deliver the child. The risks of facial paralysis can also increase with a larger baby, long labor, or the use of medications to induce labor or cause strong contractions.
In many cases, facial paralysis is only temporary. However, if the issues do not resolve, it could indicate severe damage or a severed nerve. Surgery may be required. It could result in more long-term injuries, including speech issues, physical dysfunction, difficulty speaking, difficulty expressing emotions, and difficulty chewing. Talk to your doctor if you have concerns about temporary or continuing Bell’s palsy facial paralysis.
Brachial Palsy and Shoulder Dystocia
There are a collection of nerves between the head and shoulders known as brachial plexus nerves. These allow for functions of the hands and arms. During some deliveries, these nerves can be damaged, causing a loss of full function of the arms and hands.
Also known as shoulder dystocia, the baby may lose the ability to fully flex and rotate their arm. The injuries can improve if the nerves only have minor damage. However, if the nerves are torn, it can lead to permanent nerve damage. Sometimes called Erb’s palsy, severe damage can leave the child with nerve damage, pain, loss of range of motion, light paralysis, or hand dysfunction.
Klumpke’s palsy is another type of brachial plexus injury. Symptoms can include poor reflexes, paralysis, minimal hand movement, muscle weakness, or sensory loss.
Fortunately, only a small percentage of children with brachial plexus palsy suffer permanent damage. If you have concerns about nerve damage during delivery, talk to your doctor. If you believe your child’s shoulder dystocia was caused by a negligent delivery, talk to a medical malpractice attorney for advice.
Fractures and Delivery Complications
Fractures can involve broken bones from birth trauma. These injuries are often caused by abnormal presentations and difficult deliveries. Of the fracture injuries during delivery, the most common bone fractures are clavicle fractures. The clavicle is the collarbone. Risk factors can also include large birth weight, assisted-delivery devices, and narrow birth canal.
Signs of a birth canal can include fussy or crying babies, or babies expressing pain when lifted from under their arms. A clavicular fracture can also show as a child not being able to move one arm as well as the other or a slumping shoulder. Clavicular fractures can also occur with brachial plexus nerve damage or shoulder dystocia.
In many cases, the fracture will heal on its own but the baby may have a lump form where the new bone develops. A doctor may use a splint or bandaging to help the bone heal.
According to a study published in the journal Cureus, some of the identifiable risk factors for neonatal birth injuries can be classified into 3 categories:
- Fetal presentation
- Delivery mechanisms
- Maternal factors
The fetal presentation can impact delivery complications. In a normal presentation, the baby appears head first facing backward. Abnormal presentations include:
- Facing forward
- Face first
- Brow first
- Breech (bottom first)
- Shoulder first
According to the study, the breech presentation can result in brachial plexus palsies, intracranial hemorrhage, gluteal lacerations, and bone fractures. “The rate of birth injuries for infants with breech presentation born by cesarean delivery without a trial of labor is 0.6%, 1% for cesarean delivery with labor, and 3% for the vaginal delivery.
What Can I Do If I Suspect a Birth Injury?
If you suspect a birth injury, seek medical attention from your doctor. Getting medical attention early can help improve the chances of recovery for some birth injuries. After getting help, if you suspect the birth injury was caused by negligent medical care, talk to a medical malpractice attorney about your legal options.
An experienced birth injury lawyer can review your case and identify any possible causes of the birth injury with a medical expert. Your attorney can file a medical malpractice lawsuit to help you and your family recover financial compensation for medical bills, loss of earnings, and pain and suffering.
If you think you may have been injured because a doctor made a delivery error, get the right legal team on your side. Experienced medical malpractice lawyers, like the trial attorneys at Gilman & Bedigian, have extensive experience in malpractice claims because they focus on just these types of cases.
With the right law firm on your side, you will have the resources to help you recover damages after suffering a birth injury. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.