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Birth Injuries: Causes and Investigation

When a baby is injured during labor or delivery, what is supposed to be a wonderful, joyous occasion can turn into a frightening and sometimes tragic event. The parents may have many questions. Will my baby ever recover? Could this have been prevented? Should my doctor have done something differently? How will we pay for our baby's medical expenses? What are our options? If the baby's injuries were caused by a doctor's negligence or malpractice, the parents may want to explore filing a case for medical malpractice. This article explains some of the more common birth injuries and how attorneys investigate birth injury cases and prepare for litigation.


Types of Birth Injuries

Cerebral palsy is a term that refers to neurological disorders that permanently affect body movement and muscle coordination. In many cases, cerebral palsy can be prevented. Often, medical malpractice or negligence is to blame. Cerebral palsy can be caused by lack of oxygen to the baby's brain, an obstructed delivery, from the use of forceps or a vacuum extractor and anesthesia errors (over-sedation of the mother). If a mother is pregnant with multiples (such as twins or triplets), is age 35 or older or has placental problems during the pregnancy, she and the baby should be closely monitored by doctors during labor and delivery. The baby's heart rate should be monitored and if fetal distress is detected and the baby needs oxygen, it may be necessary to do an emergency C-section. If a doctor fails to monitor the baby's condition or perform an emergency C-section when indicated, it can be medical malpractice.


Erb's palsy is caused by stretching or tearing the nerves from the baby's neck to the arm. Certain factors make the risk of Erb's palsy greater, including a mother who has diabetes, a large baby (over nine pounds) and if it is the mother's first pregnancy. Erb's palsy is preventable. The mother should be monitored during pregnancy to be sure that the baby is not too large for vaginal delivery. A brachial plexus injury can be mild or result in total paralysis, and it may require multiple surgeries, which may or may not be successful.


Shoulder dystocia happens when a baby's head is delivered, but the baby's shoulders get stuck. It can happen where the baby is too large or the mother's pelvic opening is too small for the shoulders to fit through. Risk factors for shoulder dystocia include: a very large baby, a mother with diabetes, a mother who is pregnant with multiples, an obese mother and a mother who delivers after her due date. Possible injuries to the baby include injuries to the nerves in the shoulder, arm or hand, which may cause shaking or paralysis; a broken collarbone or arm; and lack of oxygen to the baby.


Experience of the doctor is a key factor in preventing shoulder dystocia. Inexperienced doctors or recent medical school graduates may not know how to deliver the baby without additional trauma. For example, pulling on the baby's head causes injury to the brachial plexus, and having the nurse push on the mother's belly actually pushes the baby's shoulder into the mother's pubic bone. 


Investigation of a Birth Injury Case by a Lawyer

When parents decide to sue after their child suffers a birth injury during labor and delivery, their attorney will thoroughly investigate all the circumstances of the mother's pregnancy and the labor and delivery. The attorney will review all the mother's medical records to see if she received proper care based on her circumstances (for example, whether it was her first pregnancy, if she carried multiples, if she had Type 1 or 2 diabetes/gestational diabetes, if the baby was large and the mother's age). The attorney will also review results of all tests that the mother received and investigate whether the doctor ordered proper tests and monitoring. For example, a mother of a certain age may need amniocentesis; tests to determine the growth rate of the baby may need to be done; and tests to check the progression of large babies of diabetic mothers may be necessary.


The attorney will also review the circumstances of the labor and delivery and try to determine if the mother and baby received proper care by answering the following questions:

  • Was there an obstetrician or midwife?
  • Was there fetal monitoring?
  • Were there any issues that suggested the baby needed to be delivered sooner?
  • When did the mother's membranes rupture?
  • Was the mother given the proper antibiotics?
  • Did the baby need to be born by C-section?
  • Did the doctor monitor the mother's condition and examine her frequently enough?
  • Did the baby's heart rate drop? If so, was this monitored and properly cared for?
  • Was there a timely delivery? If not, how long was the delay and why was there a delay?
  • Once the baby was delivered, were the proper care measures taken?

The attorney will usually work with experts when developing the case. Having a lawyer who has a medical background or who has significant experience with medical malpractice cases is beneficial because he or she will likely understand medical records and terminology and be able to easily work with a medical expert. 


Information provided by Law Doctors.



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