The journey of pregnancy is filled with joy, excitement, anticipation, and also some anxiety for expecting parents. Bringing a new life into this world is one of life’s most precious gifts. However, pregnancy and childbirth also come with their fair share of challenges and potential complications.
As an expecting parent, it is important to educate yourself on all aspects of pregnancy, delivery, and your newborn’s health. One area that is especially important to learn about is birth injuries. While modern medicine has made great strides in preventing birth injuries, they can and still do occur. Having some awareness of the common types of birth injuries, their causes, symptoms, and treatments can help you be proactive and prepared as you enter this new chapter.
In the United States, around 7 babies per every 1,000 births experience a birth injury. Being informed and maintaining open communication with your doctor gives you the best chance at preventing and properly addressing any birth injuries, should they arise. Below are the ten things for expecting parents to know about birth injuries. Forearmed with knowledge, you can approach your pregnancy and delivery with greater confidence.
1. Advocate for Your Baby
You are your child’s first and best advocate. Ask questions, voice concerns, and work as an active partner with your obstetrician. Follow your instincts if you feel your baby’s health is compromised during labor, and don’t hesitate to request additional medical support.
If you believe there’s been negligence that led to a birth injury, consulting with birth injury attorneys can provide guidance on your rights and potential recourse. They can assist in ensuring the best care and support for your baby’s future.
2. Head Molding is Normal
As your baby’s head passes through the birth canal, it will elongate and change shape to fit through the narrow passageway. This process is called head molding, and it is completely normal.
Your baby’s skull bones are not yet fused together, allowing them to shift and overlap during delivery. This temporary reshaping of the head does not harm the brain in any way. Within a few days after birth, your baby’s head will regain its normal rounded shape. There is no cause for concern or need for treatment with simple head molding.
3. Head Injuries are the Most Common
While the majority of babies emerge unscathed from the birthing process, some do sustain mild injuries. The head is the most frequent site of injury, given its position during delivery. Common head injuries include swelling, bruises or scratches on the scalp, and bleeding under the scalp.
Cephalohematomas are collections of blood trapped under the periosteum, the fibrous covering over the skull bone. They often resolve on their own within a few weeks to months. More serious is a subgaleal hemorrhage, which is bleeding beneath the scalp itself. This type of bleeding carries greater risks and requires close monitoring. Skull fractures are rare but may produce an indentation if depressed.
Overall, many minor head injuries heal quickly without intervention. But significant bleeding requires prompt evaluation and treatment.
4. Brain Bleeding Can Occur
Another potential birth injury is bleeding in and around the brain (intracranial hemorrhage). This can arise from the rupture of blood vessels during delivery. Preterm infants are at higher risk, as are babies with bleeding disorders. Symptoms may include seizures, poor feeding, and lethargy.
Bleeding can happen in several areas like the subarachnoid space, between the brain and its outer covering (subdural), between the skull and outer brain covering (epidural), and within the brain tissue itself. Imaging tests like CT or MRI scans are needed to assess the location and extent of bleeding and determine appropriate treatment.
Make sure to manage problems like anemia or seizures. Most cases of minor bleeding resolve without lasting effects. But significant hemorrhage can lead to long-term neurologic impairment.
5. Facial Paralysis Can Occur
Compression of the facial nerve is another common birth injury, temporarily paralyzing facial muscles on one side. When the baby cries, the face appears asymmetrically distorted. This results from pressure on the nerve from the baby’s positioning in the uterus or birth canal. It also may arise from the use of forceps during delivery.
The paralysis usually resolves fully within a few months without treatment. Congenital facial paralysis stemming from underlying disorders follows a different course. Therefore, persistent facial weakness warrants specialized evaluation.
6. Brachial Plexus Injuries Cause Arm Weakness
The network of nerves supplying the arm and hand can become overstretched during labor, damaging the brachial plexus. This may result from a difficult delivery requiring manipulation of the baby’s shoulders or neck. Weakness confined to the upper arm and shoulder is known as Erb’s palsy. Hand and wrist weakness is called Klumpke’s palsy.
Mild injuries often resolve quickly, while severe cases may require physical therapy and sometimes surgery. Proper positioning and range-of-motion exercises are key during recovery. Most babies fully regain normal arm and hand strength.
7. Early Resuscitation is Vital in Asphyxia
Interruption of blood flow or oxygen supply before, during, or after birth is called perinatal asphyxia. It can arise from cord compression, placental abruption, infections, and other causes. Prompt delivery room resuscitation is essential to prevent organ damage and death.
Supportive measures include oxygen, chest compressions, intubation, and IV fluids. Additionally, cooling therapy may help.
While injuries to the heart, lungs, kidneys, and other organs usually resolve, brain damage can result in developmental delays, learning disabilities, or cerebral palsy. Still, with quick intervention, many newborns recover fully.
8. Jaundice Requires Monitoring
While not due to birth trauma, neonatal jaundice is a common condition needing vigilance. It results from a buildup of bilirubin, a byproduct of red blood cell breakdown.
Mild jaundice is normal in newborns, but high bilirubin levels can cause brain damage, called kernicterus. If jaundice develops early or seems excessive, your baby will need blood tests and phototherapy. An exchange transfusion is rarely required. Most jaundice is temporary and harmless with proper treatment. But left unchecked, it can lead to serious consequences.
9. Infection Risk Increases with Instruments
The use of forceps, vacuum devices, or fetal scalp monitors increases the risk of bruising or lacerations on the baby’s scalp or face. These breaks in the skin raise the chance of newborn infections like facial cellulitis. Signs include swelling, redness, pain, and fever.
While usually managed with IV antibiotics, severe cases can spread to the brain. Any signs of infection after an instrumented delivery call for prompt evaluation. Catching and treating any infection early is of significant importance.
The joy of childbirth may be marred for some families by the occurrence of a birth injury. While not every injury can be prevented, many can be avoided or minimized through proper prenatal care and judicious use of instruments during delivery. For babies affected, close monitoring and early treatment provide the best outcomes. Staying educated on the risks and recognizing warning signs allows you to give your newborn the healthiest start right from birth. With information and vigilance, you can help make your baby’s arrival into the world as safe as possible.