Signs of Trauma: During Birth

Some (but not all) birth injuries are immediately apparent after birth. Common indicators of birth trauma are the following:

• Lethargic or sluggish responses by the baby,

• Slow breathing,

• Slow heart rate,

• The baby’s skin color is pale or blue,

• Difficult feeding or no interest in feeding,

• The baby favors one side of the body,

• The baby’s movements are unusual (could indicate seizures),

• Abnormal neonatal reflexes (such as failure to respond to loud noises or doesn’t grasp objects),

• The baby feels floppy (hypotonic) or stiff (hypertonic), and

• Low APGAR scores (appearance, pulse, grimace, activity, and respiration).

A low APGAR score means the baby is experiencing more than one of the previously-listed symptoms and could indicate a series of injuries.

Signs of Trauma: in Childhood

Some symptoms of birth injury aren’t apparent until the child is older and misses key development milestones. For example, if the child struggles with learning disabilities, speech development, motor impairments, or behavioral problems, these could indicate brain injuries that occurred during birth. Further indicators include seizures, vision and hearing impairments, sensor processing issues (over-or under-stimulation), cerebral palsy, and microcephaly (smaller head size).

Common Birth Injuries

There are many types of injuries, from head trauma to broken bones. Below are the most commonly occurring injuries.

Oxygen Deprivation

Birth asphyxia occurs when the baby is deprived of oxygen around the time of birth. When the brain is deprived of oxygen, hypoxia, or hypoxic-ischemic encephalopathy (“HIE”) damages the brain due to inadequate blood and oxygen levels. HIE can also damage other organs due to spreading cell death. Birth asphyxia can be prevented with prompt medical intervention, such as therapeutic hypothermia.

HIE can result in many different situations. A common instance where this does occur includes placental abruption, which is when the placenta separates from the uterine wall before birth. Umbilical cord complications, such as the cord being wrapped around the baby’s neck, are another common cause. Uterine rupture occurs when the uterus tears resulting in a massive hemorrhage. The medical staff can track when the fetus is experiencing distress based on its heartbeat. If the monitor indicates stress, the usual course of action is to deliver the baby as soon as possible to minimize injury.

Trauma

Traumatic births occur when there is significant pressure or torsion on the baby. Usually, traumatic births are avoided because the doctor closely monitors the mother during the baby’s development and, in consultation with the family, develops a birthing plan. If the doctor determines that a safe vaginal birth is unlikely, the usual course of action is to deliver the baby by C-section to reduce trauma.

Traumatic births can occur in different ways. However, a typical example includes abnormal fetal positions, such as a breech presentation. The baby needs to be positioned in such a way as to allow the mother to give birth safely. If the baby is not properly oriented, birth becomes extremely difficult, and the baby could suffer trauma.

Sometimes babies are stuck in the birth canal because the infant's head is larger than the mother’s pelvic bones (macrosomia). Doctors can also injure babies by improperly using forceps or vacuum extractors, which can put tremendous pressure on the head. Finally, the baby can also experience trauma if it takes too long to travel down the birth canal resulting in pressure on the head from repeated contractions.

Premature Birth and Related Traumas

When a baby is born early, the organs and tissues may not completely be developed. Therefore, a premature baby may require medical intervention to support the baby’s functions until the body develops. If the baby requires medical intervention, he or she is placed in the neonatal intensive care unit (“NICU”).

Birth injuries sometimes occur in the NICU. For example, if the baby is unable to breathe independently, he or she is placed on a breathing machine. The machine must be precisely calibrated to specific needs, or the infant could be overventilated. Overventilation occurs when there isn’t enough carbon dioxide in the baby’s blood, resulting in brain and tissue loss.

Another common NICU injury involves neonatal hypoglycemia (low blood sugar). Glucose (sugar) is the brain's only source of energy. If the baby isn’t properly fed, his or her glucose levels could drop to dangerous levels, resulting in brain injuries.

Babies in NICU are constantly monitored because their medical needs are unique and continuously evolving. The medical staff must carefully adjust the machines supporting the baby’s functions.

Infections

While in the womb, babies are protected from the bacterium and viruses in the mother’s body. However, as the baby is born, he or she is exposed to these bacteria and viruses, which can result in serious injury. Doctors should test the mother for certain maternal infections and, if present, these infections should be treated before the baby is born. Untreated infections can result in encephalitis, pneumonia, and meningitis.

Treatment and Long-Term Care

Birth injuries often result in substantial medical costs and the need for long-term care. Modern medicine and treatment can usually help ensure that babies suffering from birth injuries live long, meaningful lives – but medical treatment will generally cost substantial amounts of money. These injuries often result in debilitating mental and physical ailments that burden the baby and family. To provide for the baby’s long-term care, a parent will usually have to sacrifice his or her career. Therefore, families working their way through a birth injury often suffer a reduction in income because of the extra personal burdens placed on the family.

Birth traumas are a type of personal injury claim that lawyers bring on behalf of clients. A medical malpractice suit's goal is twofold: (1) to win enough money to provide long-term care and treatment for the injured baby and (2) to discipline the doctor to reduce negligent behavior in the future. A successful medical malpractice claim will ensure that the family can pay for the child’s long-term care and treatment despite the expected income loss.

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