The term ‘Birth trauma’ is used to describe any cuts, fractures, or other injuries sustained by a newborn baby during labor or delivery. Birth trauma is more common in developing nations, but at least 2% of live births in the U.S. are adversely affected by non-congenital physical injuries.
Birth trauma occurs more frequently among larger-than-average babies, particularly when the mother’s pelvic area may be too small to birth the baby without the assistance of hands, forceps, or vacuums to ease their passage through the birth canal. In these situations, neonatal injuries can occur if a doctor uses too much physical force while handling the baby or is not careful with birthing instruments.
Data suggests the most common conditions contributing to birth trauma include:
- Babies heavier than 8 lbs 13 oz
- Babies born prior to the 37th week of pregnancy
- The mother’s pelvis may have the wrong shape or size for a safe delivery
- Difficult labor or delivery (dystocia)
- Prolonged labor
- Abnormal fetal position at birth (baby is in a head-up, buttocks-first, or breech, position)
The most common traumatic injuries include:
- Caput Succedaneum – a condition marked by scalp swelling, typically during or shortly after birth. Caput succedaneum can also be caused by the use of vacuum extraction devices during a protracted delivery.
- Cephalohematoma – an accumulation of blood below the protective membrane that covers an infant’s skull. This condition manifests as lumps on a baby’s head, usually several hours after delivery. The lumps feel soft and may show signs of post-partum growth. Though most do not require medical attention, some may cause jaundice.
- Bruising and Broken Bones – Bruising may occur due to the physical stresses of the passage through the birth canal or the use of forceps during delivery which can on a newborn’s head or face, especially when medical staff use too much force. In addition, vacuum extraction may cause lacerations or bruising on a baby’s scalp. Broken bones can occur with improper use of birth-assisting tools or when an infant is tugged too forcefully. In extremely rare instances, a physician or someone on the medical staff may drop a newborn.
- Subconjunctival Hemorrhage – bleeding that occurs when small blood vessels in the baby’s eyes break. This does not cause permanent damage to the eyes and typically clears within a matter of days as the body reabsorbs the blood.
- Bell’s Palsy – occurs when a baby’s facial nerve is damaged during labor or birth usually caused by pressure on the infant’s face during the passage through the birth canal. However, facial paralysis can be caused by large amounts of pressure from forceps during delivery. Bell’s palsy is usually most evident when babies cry and the facial muscles on the damaged side remain dormant while the eye remains open. If the nerve is bruised, treatment will usually be unnecessary and the damage will improve with time. For severe cases, surgery may be necessary.
- Oxygen Deprivation – this type of birth of trauma can occur if the placenta separates prematurely or if the umbilical cord becomes entangled around the baby’s neck and reduces oxygen flow to the brain. This can lead to partial or total blindness or even permanent disabilities like cerebral palsy.
- Fractures – most common birth trauma, usually affecting the collarbone and usually occurring during breech births.
Not all birth traumas are life-threatening; conversely, most heal on their own without serious medical intervention. Many can be avoided when medical professionals are proactive and properly assess birthing situations.