10 Questions to Ask your Doctor about Birth Injuries in Newborns

Healthy moms and healthy pregnancies should result in healthy babies.  Sadly, birth injuries in newborns occur in about 7 out of every 1,000 births.  Birth injuries are injuries that occur during labor and delivery, very frequently occurring during passage through the birth canal.

Birth injuries are distinct from birth defects because of one dividing factor – liability.  A birth defect is the sad outcome of injury, illness, or congenital factors that cannot be prevented.  A birth injury is an injury or illness caused by negligence, which can be prevented.

Questions about Birth Injuries in Newborns

If you are expecting a baby, consider asking your doctor these 10 questions about birth injuries in newborns:

1. What are the risk factors for birth injuries in newborns? 

Long and difficult deliveries are the number one risk factor for birth injuries in newborns.  Particularly large babies and babies that present in an abnormal position also increase the risk of birth injury.  Thankfully, birth injuries caused by prolonged or difficult labor are less common today than they were even a few decades ago.  Modern standards of care suggest Cesarean section (C-section) delivery after prolonged and difficult labor instead of forceps-assisted delivery, which was the standard of care not long ago.

2. How do I recognize a newborn head injury? 

Head injuries are the most common birth-related injury.  Babies born via vaginal delivery are supposed to be born head first.  Your newborn’s head may have an initially unsettling appearance, but this alone may not be cause for concern.  Talk to your doctor about the normal appearance of a newborn’s head versus the signs of a birth injury in your newborn.

For example, head molding is not a birth injury.  The classic cone shape of a newborn’s head is the result of natural pressure during delivery and will resolve on its own.  Swelling and bruising on the scalp is something different, however, and may indicate a birth injury.  A pulsing bump on your baby’s head may indicate a cephalohematoma, which is usually a birth injury.

3. What are the signs of facial nerve damage?

The telltale sign of any kind of nerve damage is muscle weakness in the affected area.  With facial nerve damage, generally the baby’s face will be lopsided when making a facial expression.  It will be easiest to observe the signs of facial nerve injury when the baby is crying.  If the facial nerves are damaged, one side of the face will probably hang slack.

Some facial nerve damage is caused by the position of the baby’s face against its mother’s pelvis during labor, but it is most commonly caused by use of forceps during delivery.  Improper use of forceps is a common cause of birth injuries in newborns.

4. When should I suspect a brachial plexus injury?

A brachial plexus injury is a very serious nerve injury to a complex cluster of nerves located under the collarbone.  The brachial plexus sends nerve impulses from the lower extremity to the brain and from the brain to the upper extremities.

A brachial plexus injury can manifest with weakness or paralysis in the baby’s arm (Erb’s palsy) or it can present with weakness or paralysis in the lower extremities.

5. Which birth injuries in newborns indicate use of excessive force?

Almost any injury a newborn baby suffers that results in catastrophic injury may have been caused by the excessive use of force.  Excessive force injuries are most often associated with the overzealous use of forceps during delivery.  Excessive force can also be applied via pulling or tugging on the baby in an effort to aid delivery.

Examples of excessive force injuries include brachial plexus injuries, spinal injuries, broken bones, and nerve damage.

6. Should I worry about a broken collarbone?

If you have a particularly small frame, or are pregnant with a large baby, you may be concerned about collarbone injuries.  Surprisingly, most broken collarbones in newborn babies are not preventable birth injuries.  It is fairly common for babies who weigh over 8 pounds at birth to fracture their collarbones during their passage through the birth canal.  As long as the growth plate of the clavicle was not involved in the break, the bone will heal on its own within a few weeks.

Other broken bones are almost always an indicator of a birth injury, however.  The most common broken bones that are birth injuries in newborns are breaks in the long bones of the arms and legs, or skull fractures.

7. Under which circumstances could my baby suffer lack of oxygen at birth?

During labor and delivery, babies receive all the oxygen they need through the umbilical cord.  Compromising the cord means compromising the baby’s oxygen.  The most common causes of lack of oxygen at birth include:

8. What are the signs of organ damage from lack of oxygen?

Oxygen deprivation affects each of the organs differently.  Expect organ damage if your baby suffered a cord injury and has the following symptoms:

  • Heart – Poor skin coloration, low blood pressure, low platelet count and bleeding
  • Lungs – strained breathing and low oxygen levels
  • Brain – Lethargy, listlessness, seizures, or coma
  • Kidneys – inadequate output of urine
  • Liver – Difficulty digesting milk or formula

9. What is your plan for treating any intracranial bleeding that develops?

One of the scariest birth injuries in newborns is intracranial bleeding.  Most babies who have bleeding within the skull won’t have any symptoms.  Symptoms that are present cannot be communicated or reported.  A brain bleed in a newborn is often the result of trauma during pregnancy or delivery, or shortly thereafter.  Responsible doctors should order CT scan and MRI of babies who endured particularly difficult births.

Most babies with intracranial bleeding will spend several days in the NICU getting intensive care with warmth, fluids, and medical assistance for body functions.  More severe bleeding or hemorrhage may require surgery to remove the blood.

10. When would you perform an emergency C-section to prevent a birth injury?

Responsible physicians can rely on prenatal assessments to plan a c-section if they expect an increased risk of birth injury.  During labor and delivery, a doctor may order a c-section to prevent a birth injury if:

  • The baby is too large to move through the birth canal (fetal macrosomia)
  • Labor has extended beyond the recommended duration
  • The baby is in distress
  • The baby is in a suboptimal position and cannot be turned
  • There is umbilical cord compression affecting baby
  • Signs of placenta issues
  • The mother is in distress, has high blood pressure, or signs of preeclampsia

Talk to your doctor about his or her policy on when a c-section is advised, and under what circumstances.

Get Help with Legal Questions about Birth Injuries in Newborns

At Birth Injury Guide, our goal is to provide families with as much information as possible about birth injuries and their legal rights.  If you have questions about a birth injury your child is battling, contact us for an individualized consultation.

Your consultation is completely free, so you are under no obligation.  Get answers to your questions by calling us at 1-877-415-6603, or submit our online contact form.

Meagan Cline

Written By Meagan Cline

Meagan Cline is a professional legal researcher and writer. She lends her expertise to the team at Birth Injury Guide to provide up-to-date and relevant content that clients can count on.