Childbirth has been a vital part of human existence from its very beginning but this does not make the process any simpler. Many times, complications or mishaps can take place during the event, which may result in problems to the mother or the baby, or both of them. Birth trauma is one of them. It refers to any kind of injury, such as cuts or fractures, which may be sustained by the newborn during the labor or delivery process. Such an injury is not at all related to the congenital conditions and may be caused by mishandling of the baby by the medical staff or improper use of instruments during the childbirth. Such events are more common in developing nations of Asia and Africa, though even the US has seen the incidence of such traumatic incidents. Research has shown that on an average, 29 out of 1000 newborn babies in the country are inflicted by a physical injury of one type or the other.
Common Causes Of Birth Trauma
Birth injuries are more common in the cases when the baby is heavy and large in relation to the pelvis of the mother. In such cases, it is not possible for the baby to come out naturally during a vaginal delivery. As a result, use of hands, vacuums or forceps becomes necessary to facilitate easy passage of the baby through the mother’s birth canal. At this time, there are chances of the baby being physically injured if not handled gently by the doctor or in case proper caution is not exercised with the instruments used in the process.
Here are the common conditions where the risk of birth defect or trauma is elevated:
- The weight of the baby is more than 8 pounds 13 ounces
- The delivery is taking place before 37th week of gestation
- Prolonged and/or difficult labor
- The baby is in breech position or some other abnormal position like buttocks first
- Rapid delivery due to acceleration of birth
- Fetal anomalies like large head
- Extraction with forceps or vacuum
- The shape and size of the mother’s pelvis is not conducive for safe delivery.
Though these conditions elevate the risk of trauma, the fact is that an able and experienced doctor can ensure that the baby comes to the world safely, without being injured during the most complicated of childbirth. At the same time, the advancement of technology and popularity of Cesarean births has reduced the incidence of birth trauma around the world.
8 Types Of Injuries Caused By Birth Trauma
Childbirth is a process involving contractions of the pelvic region and the process needs to be assisted with extra pressure or instruments in some cases. Excess pressure or wrong use of instruments can lead to diverse injuries to the newborn baby. Since the baby commonly comes out of the birth canal in a head first position, the head, neck and the shoulders are most likely to be affected by the mechanical forces exerted during an assisted birth.
Here are the most common injuries caused during birth trauma:
1. Caput Succedaneum
One of the most common physical injuries inflicted on a new born during a traumatic birth is Caput Succedaneum, which is characterized by the swelling of the scalp becoming visible right after birth. It is manifested in babies who have undergone long and hard labor during which extreme pressure has been exerted by the vaginal walls or the uterus. It usually happens when the amniotic sac has ruptured early during the childbirth or in cases where vacuum extraction technique has been used.
2. Bruises and Broken Bones
Bruises may be noticed on the head, face or other body parts of the baby. They may be caused by abrasion caused by the pelvic bones and muscles of the mother or the extreme stress caused during passage through the birth canal. Similarly, rough use of vacuum or forceps may also lead to bruising. In some cases, when the baby is tugged too hard or instruments used forcefully, the infant may suffer from acute conditions like broken bones. In very rare cases, medical staff may have dropped the baby causing broken bones.
Cephalohematoma is a condition when lumps are formed on the baby’s head after delivery and they may increase in size with the passing hours. They occur because blood is accumulated below the periosteum, the protective membrane over the skull. The condition subsides with the passage of time, as the accumulated blood is reabsorbed by the body, and generally does not require treatment.
4. Subconjuvital Hemorrhage
Subconjuvital Hemorrhage refers to the breakage of small blood vessels in the eyes of the newborn, which becomes visible in the form of a red band around the iris. It is not a serious condition as no permanent damage is inflicted to the eyes. Rather, the red band vanishes in a few days as the body reabsorbs the blood.
5. Bell’s Palsy
Bell’s palsy is a condition when the facial nerves of the baby get damaged due to extreme pressure caused during a difficult labor. Wrong use of forceps which pulling the baby out of the birth canal can also cause the condition. The damage becomes visible when the baby cries and is not able to move the muscles on one side of the face and neither can close the eye on that side. In most cases, Bell’s Palsy is recovered without treatment as the bruised nerve heals itself, while surgery may be required if the nerve is torn.
6. Brachial Plexus Injury
This condition occurs when the nerves of spinal cord are injured and the baby cannot flex one of his arms. It occurs in difficult births when the baby is positioned shoulder first and has to be pulled out from the shoulder. Physical therapy may be used to treat bruised nerves in such cases, but for those with torn nerves, the damage may be permanent.
7. Oxygen Deprivation
A baby becomes deprived of oxygen before the birth because of cord being entangled around the neck or premature separation of placenta. The same can happen after birth if he does not breathe independently. In both cases, severe brain damage in the form of cerebral palsy, blindness, hearing impairment and learning disabilities, and even death can take place.
Another common birth injury is fractures, mostly of collarbones. This is common in breech births or those where the baby is positioned shoulder first. The condition is painful and has to be supported with a splint or soft bandage until it heals.
Most of the time, birth traumas are not serious and heal on their own, but it is better to ensure that they are avoided, as the baby suffers due to them. Regular monitoring of the fetal position before birth, proper handling of instruments, experienced doctors and good care can be steps to avoid their occurrence.