Giving birth is a scary thing, and not just for the reasons you think: yes, it’ll probably be painful for mom (sorry, ladies, there aren’t a lot of ways around it), but more than that, a long and hard labor can put a lot of stress on the baby too, and even cause physical injuries.
Most birthing-related injuries occur when the baby is significant in size, or the mother is small; the other most common reason for injury is if the baby is delivered breech (meaning bottom first, rather than head first). Some injuries will be prevented if the doctor or midwife recommends a cesarean section if labor is going on too long, so make sure to rely on the opinion and experience of the medical team, even if it goes against what you had planned for your baby’s birth.
It’s a relief to know that a lot of birth-related injuries to the baby are not at all fatal, and many will heal quickly, between 10 days and 6 months, depending on the severity and type of injury. According to one Canadian study, trauma to the infant occurs in just 2% of births, so the odds are in your favor that your baby won’t be at risk.
Even so, if you’re the type of person who likes to be informed, this list helps to break down the type of injuries that can occur, and explains the Latin words, since medical words are not at all easy to decipher.
15 When Baby Has A Skull Injury
Cephalohematoma, a condition when bleeding occurs between the baby’s skull and the thin membrane that covers the surface of the bone, occurs in approximately 1% to 2% of births, so it’s quite rare. A hematoma is a swelling of clotted blood between tissues; cephalo means “relating to the head or skull”; so a cephalohematoma is a blood clot on the skull. It usually occurs due to damaged blood vessels, most commonly from birth-assisting tools used during delivery, but it can also indicate an underlying skull fracture. Other causes are if the baby’s head is larger than the mother’s pelvic area, or if the labor was particularly difficult and long.
The spread of the blood clot can be contained with sutures, and cephalohematoma doesn’t affect brain cells or function. It is considered a minor birthing injury, but complications can occur, so catching it early is a must. Symptoms include anemia, jaundice, or visible bulges on the baby’s head.
14 When Baby Is Under Pressure
When the baby’s head is being squeezed for a long period of time by the dilated cervix or vaginal walls, caput succedaneum can occur, which is a fancy medical term for, simply, swelling, puffiness, and bruising of the newborn’s head. It can be barely noticeable, or quite obvious, with baby’s head appearing large and swollen, and perhaps bruised. A doctor will be able to diagnose caput succedaneum immediately with a physical exam. Like many birth injuries, it’s caused by a long and difficult labor, during which the mother has had to do a lot of pushing. The use of vacuum suction during delivery can also cause or exacerbate it.
This birthing injury is quite common, has no long-term side effects, and will go away on its own after a few days. There’s no need to intervene in any way; and indeed, attempting to drain fluid from the scalp may cause infection and other issues.
13 When Baby Is Born With Cuts
It will be upsetting to see your brand-new baby with cuts or scrapes, but birth is not only traumatic for the mother—the baby goes through an equally difficult ordeal to make its way into the world. Superficial wounds on the baby’s skin can be caused by a number of things during the birthing process. The use of forceps will often cause bruising and marks on the baby’s head and face, and vacuum suction will do the same. Babies born via cesarean section are also at risk of being cut by the scalpel blade during delivery; doctors must take great care to cut the last layer of the uterus during surgery, and in an emergency situation, this may result in a small wound on the baby’s skin.
The doctor who examines your newborn will dress any wounds that have occurred during the birth, and they should heal up quickly, but it’s always best to keep a close eye on any open cuts, keeping them clean to avoid infection.
12 When Baby’s Skin Isn’t Soft And Smooth
This injury, whose medical term is “subcutaneous fat necrosis”, will not usually be apparent at birth, but will show itself after a few weeks as hard, irregular-sized bumps on the baby’s arms, legs and trunk. These bumps will be under the skin, formed in the underlying fatty tissue. The skin in these areas will often also be red or purple-ish. The exact cause of the condition is unknown, but doctors and researchers attribute it to pressure on the infant’s body during birth, as well as stress caused by the delivery. It can also occur if the baby was deficient in oxygen during the birth, and has even been tied to hypothermia.
These bumps will go away on their own and won’t need any treatment. They may look unsightly, but it’s a rare condition and won’t recur or cause any long-term damage to the baby’s skin.
11 When Baby Can’t Move Arms
During a difficult labor, the nerves in an infant’s shoulder can be damaged. This causes Erb’s Palsy, which affects about one or two in every 1,000 babies. Baby won’t be able to move the shoulder and affected arm, as the brain’s signals won’t be able to reach the area because of the damaged upper nerves at the base of the neck near the shoulder. Infants with Erb’s Palsy are often able to wiggle their fingers, but the rest of the affected arm will look paralyzed.
Erb’s Palsy can happen when the baby is passing through the birth canal, and the arm is being pulled at an awkward angle. It is also common during a breech birth, when the doctor is delivering the baby by pulling the legs through the birth canal first.
Babies with Erb’s Palsy are referred to see a pediatric neurologist, and may need surgery within the first three to six months of their life. If the nerve damage is mild, surgery may not be needed, and physical therapy can help restore arm movement. Some babies are even given Botox injections to help heal the nerves. According to the website Birthinjuryguide.org, around 70% to 80% of Erb’s Palsy cases are righted by the baby’s first birthday with proper treatment, so while the first year will be a bit harder for these infants, by the time they are one they usually are able to develop on par with their peers.
10 When Baby Can’t Move Fingers
Very similar to Erb’s Palsy, Klumpke’s Paralysis is a condition defined by nerve damage. Klumpke’s Paralysis affects the first thoracic nerve and the eighth cervical nerve, which is to say, different nerves than those affected by Erb’s Palsy. These nerves control forearm and hand movement. It typically occurs during vaginal birth, when the baby has a high birth weight and the mother is small. The injury will occur if the doctor has to pull the baby out of the birth canal by its extended arm; if pulled too roughly, this can cause the nerves to stretch and become damaged. Klumpke’s Paralysis is about as common as Erb’s Palsy, occurring in one to two of every 1,000 babies, however it can be more painful for the infant than Erb’s Palsy.
Most infants with Klumpke’s Paralysis will recover hand and forearm function within six months, with no treatment. More severe cases will require physical therapy or even surgery.
9 When Baby Can’t Open Eyes
If, during delivery, a baby is pulled to the point of stretching and simultaneously receives rotation pressure, they can develop a cranial nerve injury. This can occur naturally, if labor is long and baby is big, and can also occur with the use of forceps. A cranial nerve injury will affect the movement in the infant’s face, so the baby may not be able to open or close both eyes simultaneously, the lower half of the face may appear lopsided when the baby cries, or one side of the face may be paralyzed. Most cases will be detected by the doctor during the baby’s first physical exam, but very mild cases may go unseen; if each side of your baby’s mouth looks different when he or she cries, it’s a good idea to show a doctor to rule out nerve damage.
The good news is that a cranial nerve injury usually gets better on its own within three months. For severe cases, surgery is needed to release pressure on the nerves, but this is rare.
8 When Baby Can’t Cry
A baby that doesn’t cry is a good thing, right? Not always. Babies with injuries to their laryngeal nerve, or the nerves attached to their voicebox, will sound hoarse when crying or making noise, and will have difficulty swallowing, The injury may also affect their breathing. Damage to this nerve can occur during a difficult birth, but it is rare; more often, this kind of injury occurs if the baby has had to have a tube in his or her throat to help breathe.
The nerve may very well recover fully on its own, depending on the severity of the injury. Surgery will sometimes be needed, and in extreme cases, if both the left and right nerves are damaged, doctors will cut a small hole in the windpipe (a tracheotomy) to help the baby breathe. This will be repaired later, once the nerve damage is addressed. This birth injury is extremely rare, so not one most parents will need to worry about happening during labor.
7 When Baby Can’t Wiggle About
A frightening yet rare spinal cord injury can occur during childbirth. It will most commonly happen during a breech vaginal birth, and will be caused by pressure, stretching and rotational stress on the baby’s body, or hyperextension of the baby’s head during a stressful delivery.
Unfortunately, spinal cord injuries can cause permanent damage, including loss of sensation, spasms, pain, breathing difficulty, and paralysis, however, many less severe spinal cord injuries can heal just fine with the help of a brace to keep the baby’s body stable. Steroid injections can also help the injury to heal fully. This will obviously be very difficult for a newborn, and the parents, to endure, but a brace is a solution to an otherwise harrowing injury. Thankfully, these kinds of childbirth-related spinal cord injuries are very rare; child and infant spinal cord injuries only account for 5% of all spinal cord injuries in the USA.
6 When All Baby Can Do Is Cry
This birthing injury will look as if your baby is paralyzed and can’t move, but actually, the infant’s clavicle (the collarbone, which runs across the top of the shoulders and breastbone) is fractured. It is the most common injury occurring during childbirth, according to the Nationwide Children’s Hospital, and it will be diagnosed by an X-ray as soon as the infant is examined by a doctor. As with all of the injuries here, the clavicle can be broken during a difficult vaginal delivery. The baby will hold one arm close to his or her body, and if baby is picked up under this arm, he or she will cry out in pain.
The best thing about this injury is that is is relatively minor, and will heal on its own within 10 days or so. There’s no treatment other than making sure to lift the baby gently so as not to cause pain to the affected area. And newborns heal so well that later in life, an X-ray will probably not even be able to detect that there was ever a break.
5 When Baby Is Born With Broken Limbs
Newborn babies’ bones are extremely fragile, so it’s not uncommon for little bones to break during childbirth. If this happens, the bone can sometimes be heard breaking or fracturing during the delivery, which is a frightening prospect, but as far as birthing injuries go, fractures are on the less severe side of things. If there is no audible sound, though, broken bones in babies can be hard for doctors to diagnose, since the child cannot tell anyone where they’re hurt. If there’s a broken bone, the area will often be swollen or bruised, and the infant may not move that limb, so if you notice any of these symptoms in your newborn, it’s best to get him or her looked at by a doctor.
The baby will usually be fitted with a tiny splint or cast to stabilize the limb as it heals, just as adult bone fractures are. Doctors will also do tests for nerve damage to the area.
4 When Baby Is Bleeding On The Inside
If the birth is difficult and long, the baby might be at risk of sustaining an injury that will cause abdominal bleeding. Newborn infants’ bodies are extremely delicate, so any prolonged pressure on their internal organs can cause complications like a ruptured spleen or a tear in the liver. If a baby is bleeding in his or her abdomen, the tummy will stick out and look bloated, and possibly bluish. The baby will be in shock and will be pale.
The doctor will diagnose internal bleeding by inserting a tube or needle into the baby’s abdomen to check if there is fluid, or perform an ultrasound to see what’s happening within the abdomen. As long as doctors catch this early, they should be able to stop the bleeding and repair any damage. There’s a much higher possibility that internal bleeding will require surgery than many of the other injuries listed here.
3 When Baby Can’t Breathe
Hypoxia, which describes a situation involving low oxygen levels, can affect an infant during childbirth, caused by the umbilical cord being kinked or pinched, therefore cutting off oxygen to the baby during delivery. This is a frightening prospect that can have serious side effects for the baby. In the past, hypoxia or anoxia (which is the total absence of oxygen for a prolonged period of time) would definitely cause brain damage to the baby, but these days, there is treatment.
If the baby has been deprived of oxygen during the birth, they will be rushed to a hyperbolic oxygen chamber, into 100% oxygen (the air we breathe is made up of only about 20% oxygen). This can prevent brain damage, or lessen the severity of the damage. The baby will go through a number of tests to see whether brain damage occurred as a result of oxygen deprivation.
2 When Baby’s Heart Beats Irregularly
Persistent Pulmonary Hypertension of the Newborn (PPHN) is a condition that can be the result of a long and difficult vaginal delivery. Babies who have trouble breathing when first born are at risk of developing PPHN, and it can cause heart murmurs or rapid heartbeat, and cyanosis, which is when the skin turns bluish due to lack of blood circulation. The baby might appear as if it’s in shock. PPHN can also occur if the mother has high blood pressure, which can cause the baby stress during the delivery. This is an uncommon birthing injury.
The baby will most likely be put on oxygen and placed in an incubator to regulate his or her body temperature. He or she will be monitored closely and be given nutritional supplements to help with the stress to the baby’s tiny body. Only 15 years ago, PPHN caused death in half of infants who had it, but the statistics have vastly improved; nowadays, it will only be fatal in 20% of cases. Even better, only 1/5th of surviving infants will experience any long-term effects from the condition.
1 When Baby Can’t Control Movement
Cerebral Palsy, one of the most common disorders in the US, can be caused during childbirth from lack of oxygen to the baby, labor that lasted over 18 hours, or injury caused by the use of instruments like forceps or vacuum extraction. It is a type of malformation in the part of the brain that controls motor skills and is not a disease, as many people believe. This disorder affects muscle control, and there are three types, characterized by lack of movement, or paralysis, of an area or limb, spastic and uncontrolled movement of a limb, and inability to balance and difficulty with depth perception. The latter will be very difficult to detect in newborns.
Cerebral Palsy is a lifelong condition and will affect the muscle tone, reflexes, and coordination of the affected limb or area. Depending on the severity, as the child grows he or she may need things like braces, crutches, and wheelchairs to help him or her with everyday tasks.
Sources: Birthinjuryguide.org, Chdbabies.com, Healthline.com, Medlineplus.gov, Patient.info
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