Types and causes of common birth injuries in babies

Mother holding baby hand

Birth injuries in babies are devastating and very upsetting for parents. The effects of a birth injury can follow babies and their families for the rest of their lives. Here, we examine some of the causes of common birth injuries, including obstetric negligence.

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Parents of babies who suffer birth injuries often want to understand what happened during their baby’s birth. This is completely natural, and a lot of parents just want answers and an explanation of what happened. Some birth injuries are unavoidable tragedies. However, some babies who should have been born healthy are injured because of substandard care. Naturally, this is a very difficult situation for parents to come to terms with as it is so unexpected and can happen during an otherwise uneventful pregnancy.

"Parents often come to us looking for answers. They also want to ensure that their injured baby has as good a quality of life as is possible,” says Gwyneth Munjoma. “We are here to support parents through what is often the most difficult experience of their whole lives. It’s a terribly difficult situation for parents to deal with and we’re committed to securing an explanation of what happened, and an apology where necessary, for our clients. We understand that no amount of money can make up for the life-changing experiences our clients have to go through, but a settlement package can help to ease financial pressures following a birth injury. Often, the settlement provide peace of mind for the child’s future. Babies with serious birth injuries can have complex and lifelong needs which require specialist support. A settlement can cover the cost of ongoing care, accommodation and therapy – allowing the child and his/her family, to have as “normal” a life as possible.

What is a birth injury?

A birth injury to a baby is when a baby suffers injury before, during or just after birth. Birth injuries to babies are normally caused by a problem during, or just after, delivery. They can also occur in the antenatal period (during pregnancy). This can happen where there is a problem with the baby’s development, or if a condition develops during pregnancy which affects the baby’s health. Sometimes, babies suffer a birth injury and nobody is to blame, some birth injuries are not preventable or foreseeable and some could have been prevented if different actions had been taken at the time.

Birth injuries to the baby due to doctor or midwife negligence

Some babies suffer birth injuries because of substandard care by doctors, midwives or other medical professionals. It could be a problem that was overlooked during pregnancy or a problem that was not properly acted upon during the baby’s delivery. Examples of medical negligence during childbirth include:

  • failure to follow correct protocols and procedures; 
  • failure to properly monitor and record the baby’s heart rate;
  • failure to spot signs that a baby is in distress before and during labour; 
  • delays in dealing with complications during delivery;
  • delays in requesting help from senior personnel or failing to request help at all;
  • failure to differentiate between a normal and an abnormal situation;
  • mothers being turned away from maternity units despite reporting potentially serious problems.

If your baby suffered a birth injury and you have concerns about the care you received during pregnancy or labour, call us. It’s completely free, and we’ll listen to you. Our medical negligence experts are dedicated to helping parents find out what went wrong, and why.

What is the most common type of birth injury?

Minor birth injuries (such as small cuts and bruises) are relatively common in babies and normally heal within a short time. Minor birth injuries do not typically cause any lasting problems for the baby.

Serious birth injuries to mothers or babies are uncommon. The NHS recorded 8,134 cases of serious harm to mother or baby between April 2016 and March 2017. Of those, 288 cases involved death. The risk of the most serious birth injuries to babies (a death, brain injury or physical injury) is very low, but when it happens, it is heart-breaking and very difficult for a family to come to terms with. 

Types and causes of birth injury

Birth injuries can be life-changing for a child, as well as his/her parents and extended family. The following list of birth injuries, and possible causes, is not exhaustive.

Brain injury at birth

Brain injuries are one of the most serious forms of birth injuries to babies. Brain injuries are usually permanent, and can have physical and mental symptoms. Brain injured babies may suffer from developmental delays, and may not reach key milestones in time or at all (such as crawling, walking or talking). 

Every brain injury is different – the symptoms and severity can vary greatly. The most common form of severe brain injury at birth is cerebral palsy – a permanent neurological condition which affects cognition, mobility and development. 

Common causes of brain injuries at birth include:

  • Anoxia: this is where a baby is completely deprived of oxygen. Oxygen deprivation to the baby’s brain may cause brain injury and just a few minutes without oxygen may be enough to have lifelong impact. 
  • Hypoxia: this is where there is decreased flow of oxygen to the brain. A reduction in the supply of oxygen to the baby’s brain even for just a few minutes may be enough to have lifelong impact. 
  • Physical trauma to the head: physical damage to the baby’s neck or head can cause brain injury. For example, improper use of instruments such as forceps or ventouse can cause damage to a baby’s brain.
  • Infections and health problems in the mother: if a mother suffers a health problem before or during pregnancy it can affect the baby’s health, and depending on the nature of the problem, it could cause brain injury to her baby. It’s very important that caregivers recognise health problems in a mother and offer timely and appropriate treatment.

For more information about the signs, symptoms and causes of brain injury – click here.

Shoulder dystocia complications

Shoulder dystocia is a rare complication which occurs during delivery. It can happen during a vaginal delivery and affects about 1 in every 150 deliveries. Shoulder dystocia occurs when the baby’s head is born but one shoulder becomes stuck behind the mother’s pubic bone. Shoulder dystocia is not a birth injury in its own right, but if not managed appropriately it can cause injury to the baby.

Shoulder dystocia can damage the nerves in a baby’s neck, causing temporary or permanent loss of movement in the arm (Erb’s palsy). Minor injuries may heal in time but in major nerve injury cases, there can be permanent damage to the arm.

The condition can also result in hypoxia if the baby’s head is stuck at the perineum for too long. A reduction in oxygen supply to the baby can cause brain injury (such as cerebral palsy). In very rare cases, poorly managed shoulder dystocia can result in a stillbirth or neonatal death. 

Because the risks associated with shoulder dystocia are so serious, midwives and doctors must act quickly to deliver the baby. Babies in this situation often need help to be born safely. For example, the delivering practitioner might have to reposition the baby in the birth canal in order for sae delivery to take place. Shoulder dystocia can cause fractures to the baby’s neck, arms and shoulders. 

In most cases, doctors and midwives can’t prevent shoulder dystocia because there is no way to predict when it will happen. If it does happen, caregivers should identify the problem quickly and take the right actions to help the baby be born. Midwives and doctors are trained to recognise the signs of shoulder dystocia and the necessary measures to take in order for safe delivery to take place. Failure to provide the right level of care can have serious consequences, such as those mentioned above.

Obstetric brachial plexus injury

An obstetric brachial plexus injury (BPI) occurs when the nerves in the baby’s neck are damaged during delivery. The result of such an injury is a loss of movement and sensation in the arm. 

The brachial plexus is a network of nerves around the shoulder which controls movement and sensation throughout the shoulder, arm and hand. Nerve damage can occur if the nerves are stretched, compressed or (in severe cases) separated from the spinal cord. In severe cases brachial plexus injury can cause permanent damage to the arm. 
The most common type of brachial plexus injury is called Erb’s palsy. Also known as Erb’s-Duchenne palsy, Erb’s palsy normally affects the shoulder and the upper arm. It can cause partial or complete paralysis of the arm, weakness of the arm resolves within a short period of time. However, in about 1% of cases the damage is permanent. Klumpke’s paralysis is a much rarer type of brachial plexus injury which affects the forearm and the hand. It can cause paralysis of the hand muscles and weakness in the arm.

Erb’s palsy and Klumpke’s paralysis are usually complications of shoulder dystocia. In about 10% of shoulder dystocia cases, the babies suffer brachial plexus injury. 

Broken bones during delivery

Babies are at risk of broken bones (fractures) during labour and delivery. Fractures in the collar bone are the most common type of fracture babies suffer during delivery. Rarer types of fracture include the skull, the arm and the spine.

Common causes of fractures during delivery include:

  • excessive twisting or pulling of the baby during delivery;
  • improper use of instruments, such as forceps
  • shoulder dystocia.

Babies with bone diseases are particularly at risk of fractures. Certain types of bone diseases can be detected on ultrasound scanning but this is not possible in every case, particularly if the symptoms are mild.

Some fractures are unavoidable, as birth can be physically tough on mother and baby. Sometimes, the natural force of a mother’s contractions as the baby is delivered are enough to cause a fracture. Fortunately this is rare and with proper treatment, babies should make a full and speedy recovery. 

Stillbirth and neonatal death

Birth injuries can be so severe that they cause the baby to be stillborn. In other cases, the baby might survive for a short time but sadly die soon after birth. In some cases the cause of death is not known.

Losing a baby is an absolutely devastating and traumatic event. It can be incredibly difficult for bereaved parents and their families to come to terms with what’s happened. Most parents want to know what happened during their baby’s birth, and the reason why their baby did not survive.

If a baby is stillborn, or dies shortly after delivery, it can be difficult for doctors to establish the exact cause of death. A post-mortem (autopsy) might be recommended. In some cases, where the cause of death isn’t clear, the coroner may order a post-mortem. 

Potential causes of stillbirth and neonatal (newborn) death include:

  • meconium aspiration syndrome
  • imbilical cord prolapse
  • placental abruption
  • placenta praevia
  • severe hypoxia
  • traumatic injury before or during delivery
  • severe infection
  • complications due to premature birth or low birth weight
  • a developmental or genetic problem which means the baby could not survive outside of the womb.

Sadly, about 500 babies die each year in the UK because something happens around the time of their birth which was not dealt with well by the doctors and/or midwives. Research suggests that many of these deaths can be avoided with better care. If your baby was injured at birth, and you think that your delivery was mismanaged, talk to us. Our specialist Birth Injury Claims solicitors will listen to what’s happened and help you find the best way to move forward.

All content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor, any other health care professional or for the legal advice of your own lawyer. Tees is not responsible or liable for any diagnosis made by a user based on the content of this site. Tees is not liable for the contents of any external internet sites listed, nor does it endorse any service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health and your lawyer for legal advice.

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Chat to the Author, Isobel Foenander

Senior Associate, Medical Negligence, Bishop's Stortford office

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