By Sophie Bishop: Advancements in technology and the healthcare system have made having a baby the safest procedure possible. And, for the most part, childbirth goes roughly according to plan…
However, sometimes there can be complications at birth that cause an injury to the baby, the mother, or both. Sometimes these injuries are unavoidable, but in some cases, they could have been prevented.
In this article, we will be looking at five of the most common birth injuries and how to prevent them.
What is a Birth Injury?
Before we go any further, it is important to understand exactly what a birth injury is and what it can mean for a mother and or her baby.
While it is not uncommon for minor health complications to arise following childbirth, these should resolve quickly. In contrast, birth injuries can have irreversible or life-changing consequences.
Birth injuries are any injury sustained by a woman or baby before, during, or after the birth, including:
- Injuries affecting the brain or nervous system
- Infections transmitted from the mother to the baby
- Physical injuries such as broken bones
- Cerebral Palsy
According to McCarthy + Co, a birth injury specialist: “Of the types of injuries that can result from substandard medical treatment at birth, cerebral palsy is one of the most common.
“In most cases, cerebral palsy occurs spontaneously during pregnancy. However, it can also be the result of failure to intervene by medical staff at the birth, which can lead to a deprivation of oxygen to the brain.”
When a baby does not receive enough oxygen, their brain can become permanently damaged, affecting them for the rest of their lives. Cerebral palsy can vary in severity but often results in permanent physical or mental complications and is one of the most common brain injuries in children.
To prevent cerebral palsy, it is the responsibility of the medical professionals present at the birth to recognize and react to lack of oxygen within a reasonable timeframe.
Continuous monitoring of the mother and baby is imperative so that preventative measures can be taken if needed.
- Vaginal Tears During Labour
While it isn’t a pleasant topic, it is a fact that most women who give birth vaginally will experience perineal tears – the severity of which can vary widely.
According to the Royal College of Obstetricians and Gynaecologists, 9 in every 10 first-time mothers who have a vaginal birth will experience some sort of tear.
While for the most part, tearing isn’t considered a serious birth injury, depending on the severity, tearing during labour can affect a woman for the rest of her life. Below are the three most common types of vaginal tears during labour.
- Firth Degree Tears: these tears are very common for women giving birth and are only skin deep, affecting the outer layer of skin around the vagina and perineum. Women who experience first degree tearing when giving birth don’t usually suffer any long-term effects, healing quickly even if a few stitches are required.
- Second Degree Tears: these tears usually require stitching to help the torn skin heal. Second degree tears can cause a lot of pain and discomfort for the mother weeks after the birth. However, beyond this, they should eventually heal and not cause further problems.
- Third and Fourth Degree Tears: if a woman experiences third or fourth degree tearing, it is likely the size of the baby was to blame or forceps were required to assist with the birth. Serious tears to this degree can cause further health complications, including pain when passing urine or having intercourse, pain or soreness when sitting down or exercising, scarring, or rectovaginal fistula.
To prevent excessive tearing during childbirth, some women have an episiotomy. This operation involves a surgical incision at the opening of the vagina to make it wider, allowing for more room to deliver the baby.
Medical specialists will only recommend an episiotomy if it is medically necessary or in instances where the baby needs to be born quickly.
- Skull Fracture
When a baby is being pushed through the birth canal, its head comes under a lot of pressure and, in some cases, this pressure can be enough to cause a fracture. These fractures can also be caused when instruments, such as forceps, are being used to help deliver the baby.
Skull fractures come in several forms. For example, a linear fracture is simply a split in the bone which does not cause the bone plates of the skull to move. Whereas a depressed skull fracture is the result of indentation in the skull caused by mishandled instruments or an overly traumatic birth experience.
While most skull fractures will heal over time, there are some skull fractures that have the potential to go on and cause brain damage.
To prevent skull fractures, the best practice is for medical professionals to use birth assisting tools like forceps and vacuum suction properly. Through medical malpractice and misconduct, incorrect or improper use of these tools can cause serious skull fractures at birth.
- Erb’s Palsy
Erb’s Palsy is a birth injury characterised by paralysis of a baby’s shoulder, arm, or hand as a result of damage to the brachial plexus nerves during birth. Most babies born with Erb’s Palsy fully recover without treatment. However, some children require surgery or physical and occupational therapies to fully recover.
Erb’s Palsy is caused by excessively pulling on a baby’s neck or head during a particularly difficult delivery. It is also caused by the baby’s head becoming stuck under the pelvic bone during delivery.
The best way to prevent Erb’s Palsy from happening is by a doctor or midwife being careful not to strain or force the baby’s shoulder while being born.
Thorough examinations of the mother’s belly before birth will also help prepare for a safe delivery as this will alert doctors as to whether the baby is breech or not, and whether it will require medical assistance to exit the womb.
- Brain Damage
Brain damage is one of the most common birth injuries. There are numerous types of brain damage resulting from birth injuries, most of which lead to neurological or physical impairments.
Brain damage can be caused by a bleeding in the brain, umbilical cord choking, an undiagnosed brain infection, physical injuries to the head or a loss of oxygen to the brain. The severity of brain damage varies between cases, with many babies making a full recovery or living with a long-term disability.
There are many ways to reduce the likelihood of brain damage at birth, most of which are the responsibility of medical professionals assisting with the birth.
Doctors and midwives must be readily available and on-scene to assist with a fast birth if the baby is running out of oxygen, to deliver the baby safely with the cord around its neck, or to use medical tools with care so as not to cause any unnecessary force on the child’s head during childbirth.
Childbirth can be a complex process – for some women it goes very smoothly, while for others the whole experience can be very traumatic. But, as has been made clear above, good maternity care can greatly reduce the risk of birth injuries to both mother and child.
The journey of a baby out into the world can be a scary one for all involved, but knowing the risks and the best methods of prevention will helps mothers be better prepared for all potential eventualities.
Sophie Bishop is a medical journalist with a MSc of Science specialising in psychology. Sophie’s passion is to spread awareness through her writing around issues to do with healthcare, wellbeing and sustainability and is looking to connect with an engaged audience.