Parents spend nine months preparing for the arrival of their newborn, from decorating the nursery to stocking up on diapers. But what many can’t prepare for is an unexpected trauma in the delivery room.
As technically-advanced and accessible as the U.S. healthcare system is, we fail in comparison to other industrialized countries when it comes to the health and safety of our most vulnerable little ones. According to the State of the World’s Mothers report, the U.S. has the highest first-day infant death rate among developed countries – more than 11,300 newborns die within 24 hours of their birth. In addition, 3 percent of babies are born with a birth defect.
While many defects and deaths are the cause of genetic issues or an existing medical condition, there are a variety of other reasons for the numbers – a lack of prenatal care, a mother’s health, her use of drugs, and her age. However, many birth injuries and deaths happen in the delivery room, regardless of every precaution a mother takes.
Complications in the Delivery Room
There are two types of issues that can have an effect on a newborn’s health today and down the road. Birth injuries are damages to a baby’s system that occur during delivery, such as infection or a deprivation of oxygen. Birth trauma encompasses more mechanical damage to a baby’s body such as fractures or hemorrhages.
There is a number of physical complications that can lead to a birth injury or trauma, including a large birth weight, the size and shape of a mother’s pelvis, prolonged labor, and an abnormal birthing position (for instance, if the baby is breech). While these can all affect the birth, how the medical team responds to these conditions is just as important.
According to the Joint Commission on Accreditation of Healthcare Organizations, the root causes of birth injuries or trauma with regard to medical professions include:
- An organizational culture that is not conducive to effective communication between medical professionals, including a failure to function as a team and a failure to follow the chain of communication.
- Staff incompetency
- A lack of proper orientation or training
- Inadequate fetal monitoring
- Unavailable monitoring equipment or drugs
- Credentialing or privileging issues for physicians, nurses or midwives
- Staffing issues
- A delayed or unavailable physician
- Unavailability of prenatal information
For any of these reasons, a critical life-saving decision can be overlooked, the wrong procedures followed, or the wrong equipment used – all of which can have a long-lasting consequences on a family. While physicians and nurses take every possible precaution, mistakes and oversights can happen.
The Lingering Effects of Birth Trauma
Many cognitive, physical and development conditions can occur after a birth injury. Some are temporary; others can require a lifetime of rehabilitation, medical treatment and long-term care. A child may be confined to a wheelchair the rest of his life or depend on a breathing tube in order to survive.
Some of the most common birth injuries include:
- Bone fractures – the most common fractures occur to the clavicle and shoulder
- Cerebral palsy – a condition in which a brain defect or lesion affects a child’s muscle tone, posture or movement
- Brachial palsy – causes a loss of movement or weakness in the arm after the brachial plexus, or the nerves that affect the arms and hands, are damaged during delivery
- Caput succedaneum – the swelling of the soft tissues of the baby’s scalp, often caused by vacuum extraction.
- Cephalohematoma – a hemorrhage between the skull and its fibrous covering, usually caused by forceps
- Subarachnoid hemorrhage – bleeding in the area between the brain and the thin tissues that cover it, which can lead to stroke, seizures or death
- Subconjunctival hemorrhage – the breakage of the small bloods vessels in a baby’s eyes
- Facial paralysis – damage to a baby’s facial nerves; often surgery is required to restore movement
- Spinal cord injuries – damage to a child’s spinal cord – it’s most likely to occur if he or she is breech or requires manual rotation to leave the birth canal
- Perinatal asphyxia – deprivation of oxygen to a child’s brain or organ – in many cases, it can lead to developmental and intellectual disabilities.
Medical facilities and professionals are following best practices and undergoing significant training to help prevent an injury from happening to one more newborn and family. However, mistakes still happen – in fact, the birth injury rate continue to remains steady in the U.S even as professionals take the proper precautions.
Because a birth injury can leave a child with special needs for the rest of his life, his family members must understand what remedies are available to them. With a financial safety net, the family can ensure the child receives proper medical care, therapy and necessary equipment when he needs it for as long as he needs it.