Although birth trauma is relatively rare in the United States, it is estimated that 6 to 8 out of every 1,000 live births result in some type of injury, including minor scrapes or bruises. Many of these occur as a result of the baby’s passage through the birth canal during delivery. In most cases, an infant’s bruises heal on their own. However, some of these bruises may be signs of birth trauma caused by problems with the mother’s health or medical errors made by doctors or other medical personnel.
Birth Injuries Linked to Infant Bruising
Although most infant bruising is merely a side effect of the physical stresses of labor and birth, it can also be a sign of injuries sustained during delivery. These injuries can be traced to several risk factors, including difficult births. Long and arduous labors are often the result of:
- Large babies that weigh over 8 pounds, 13 ounces
- Premature babies born before 37 weeks
- Cephalopelvic disproportion, which occurs when the infant’s head is too large to fit through the mother’s pelvis
- Breech births
In difficult births, there is an increased risk that some type of birth trauma may occur. All babies can receive birth injuries as a result of prolonged labor. However, premature babies run a greater risk of being injured at birth because they are smaller and have more delicate bodies.
Difficult births require doctors to pay close attention to both the mother and baby to make sure the delivery goes as well as possible. At the same time, physicians and other medical staff have to intervene quickly to help the baby out of the birth canal, especially if either the mother or infant are in distress.
In these situations, attending doctors must use instruments such as forceps or vacuums to extract the baby. Though these medical tools are useful and solve many birth-related complications, they may create birth injuries that causes infant bruising.
Childbirth is a traumatic experience for a baby’s body even under the best of circumstances. The mother’s pelvic bones and the muscles of the birth canal exert pressure on a newborn during labor. This causes some breakage in the baby’s capillaries and venules and forms contusions or bruises.
There are three types of contusions: subcutaneous, intramuscular, and periosteal.
- Subcutaneous contusions occur under the skin.
- Intramuscular contusions occur within muscle tissue.
- Periosteal contusions affect bones.
Contusions can also be caused by the use of medical instruments, especially forceps. These tong-like instruments come in various types and sizes, but they’re used to help extract a baby from the mother’s womb, particularly in long, difficult deliveries. The pressure of the forceps’ branches upon a baby’s head or face can cause bruising. Also known as forceps marks, these bruises eventually heal on their own.
Vacuum extraction may also cause bruising to the baby’s scalp. In some cases, however, the use of the vacuum extraction, or ventouse, method can cause cuts known as lacerations. Normally, lacerations are superficial and require minimal medical treatment. However, deep lacerations may require stitches and other types of medical intervention to prevent complications.
Caput succedaneum is a medical condition marked by swelling on an infant’s scalp’s soft tissues. It is often a result of a difficult labor, especially after the uterine membranes break. Caput succedaneum is caused by pressure of the uterus or vaginal wall on the baby’s head. Bruising occurs when there’s no cushioning layer of amniotic fluid to protect the soft, delicate tissues of the baby’s scalp.
The principal sign of caput succedaneum is a soft, puffy swelling of the scalp, particularly on the part of the head that emerged first. In many cases, the condition is accompanied by bruising. Though bruises may occur naturally as a result of the baby’s passage through the birth canal, it is more likely to be caused by the use of vacuum extractors.
Cephalohematoma is an accumulation of blood underneath the bones of an infant’s skull. It’s usually noticeable several hours after birth and appears as a lump on the top of the baby’s head. These lumps only form on one side of the skull, usually at the point of most contact between the baby’s head and the mother’s pelvic bones.
Cephalohematomas vary in size; small ones may disappear within two weeks, while larger collections of blood may be visible for as long as three months. They clear up completely when the baby’s body reabsorbs the blood. If the area affected by the intracranial bleeding is large, breakdown of red blood cells may cause jaundice in some babies.
Keep in mind that caput succedaneum and cephalohematomas are not brain injuries. They are caused by trauma outside of the baby’s skull.
Although most instances of bruising are a result of the physical stresses of childbirth, they can also be caused by healthcare professionals during delivery. Although some incidents that lead to infant bruising are inevitable, some are the result of medical errors and poor judgment. Improper use of vacuum extractors or forceps may result in painful contusions or other injuries.