Some pregnancies are more difficult than others. Fortunately, modern medicine in the field of obstetrics (the branch of medicine related to pregnancy) has identified many of the risk factors. If doctors and expecting mothers can identify the risks ahead of time, they can make a plan for them to reduce the risk of a birth injury. In fact, the doctor and medical facility have a duty to understand any significant risk factors to take actions that will avoid birth injuries when possible. It’s important for expecting mothers to be aware of their own risk factors for a birth injury (such as age or obesity) as well as the types of risk factors that the fetus or pregnancy can present, which we’ll describe below.
The Types of Birth Injury Risk Factors
The risk for a birth injury can be separated into three major categories: risk factors of the procedure or tools being used (e.g., use of forceps), risk factors of the mother (e.g., the age of the mother), and, finally, risk factors related to the fetus or pregnancy.
The Five Main Risk Factors for Birth Injury Related to the Fetus
According to the National Institute of Health’s National Library of Medicine, the five fetal and pregnancy-related factors include:
- Macrosomia. This is the medical term for a baby that is much larger than average. According to the Mayo Clinic, any baby over 8 pounds, 13 ounces is diagnosed as fetal macrosomia, but babies over 9 pounds, 15 ounces, are associated with the most risk of a birth injury in a vaginal delivery. Fortunately, there are ways to measure the size of the baby in the womb.
- Macrocephaly. This literally translates to “large head.” According to the Cleveland Clinic, the fetus is diagnosed with macrocephaly if baby’s head is larger than 97% of babies of their age and gender, and it occurs in 2% to 5% of the U.S. population. Macrocephaly can be harmless, or it can be a sign of a larger problem. In terms of pregnancy, it is a condition that can make a vaginal birth very difficult. The human head is the biggest challenge in terms of squeezing through the vaginal canal, and baby with macrocephaly makes it an even greater challenge.
- Very low birth weight and extreme prematurity. According to Cedars Sinai, low birth weight babies have a greater risk of developing problems, including (among many issues), low oxygen levels, infection, breathing problems, brain bleeds, and more.
- Fetal congenital anomalies. These are probably more commonly referred to as “birth defects.” According to Boston Children’s Hospital, congenital anomalies are caused by genetic or environmental factors, and sometimes both.
- Abnormal presentation. In this context, “presentation” refers to the position the baby in the womb during labor. According to the Cleveland Clinic, a normal or ideal presentation is “head-down, facing your back, with the chin tucked to its chest and the back of the head ready to enter the pelvis.” If the fetus has an abnormal presentation (e.g., the legs, an arm, or buttocks are positioned to exit first), there is significant risk of a birth injury. One of the primary concerns is the tangling of the umbilical cord and the chances the baby will be deprived of oxygen.
Frequency & Types of Birth Injuries
In the United States, there are approximately 1.9 birth injuries per 1,000 live births. When the fetus/pregnancy presents challenges listed above, it can cause a difficult delivery, which increases the risk of a birth injury. Some of the most common birth injuries related to difficult deliveries include:
- Cerebral palsy. This is a birth injury that can dramatically impair the child’s coordination and ability to move arms, legs, or other parts of the body, and there can be even more severe symptoms and disabilities. CP has several causes, including an injury to baby’s brain during delivery
- Hypoxic ischemic encephalopathy (HIE). These are injuries and disabilities that are caused when the baby’s brain is deprived of oxygen during delivery.
- Brachial plexus injuries. These involve nerve damage at the area around the neck and shoulders of the baby, usually occurring from being stretched violently during a difficult delivery.
Who Is Responsible for a Birth Injury?
In some cases, such as with birth defects, the birth injury is unavoidable. In other situations, there is a birth injury that could have been avoided. If it is determined by experts that the doctor or medical staff did not consider the risk factors, if they departed from the established standard of care, or if they did react to an emergency in a reasonable amount of time, it can be considered medical malpractice.
Most birth injuries are minor and the baby can be expected to make a full recovery. In some severe cases, there could be a lifetime of disability and very expensive medical and developmental needs.
In situations where there is a baby with a birth injury, it is important to immediately get the facts on why it happened, and that requires professional assistance. Law firms, like Brown & Barron, have specialized expertise to evaluate the facts of a birth injury and determine if malpractice occurred. A specialist called a lifeplan expert will then work to determine the full amount the victim and the family will need to cover the economic losses and future expenses (e.g., medical, accessibility, and therapy needs) in addition to the pain and suffering that they will have to endure, perhaps for decades.