COMMON BIRTH-RELATED TRAUMAS
Written by Caroline Meyer
The birth of a child is a joyous thing, but it can also be a little frightening. It is helpful to know that birth injuries are not very common and most are not serious. Some of the most common neonatal injuries affect the neck, head and shoulders of the baby, although any part of the body can be injured. The upper body is most likely to be injured due to babies generally presenting head first. Here is a list of some birth injuries that can occur:
Cephalohematoma is when there is a build-up of blood under the protective membrane covering the baby’s skull. It usually only shows up a few hours after delivery and usually presents as lumps on the head. They feel soft and may get larger. These injuries are usually self-healing and don’t need medical intervention. Within a month or two, baby’s body will reabsorb the blood and the lumps will disappear. In severe cases, this injury can result in jaundice due to the breakdown of excessive amounts of red blood cells.
Caput Succedaneum is a swelling of the scalp that usually happens during or just after birth. It is caused from pressure of the vaginal wall or uterus during delivery or through vacuum extraction devices. This scalp bruising is usually only seen from protracted labour especially if the amniotic sac breaks early and there is no protection for baby when it passes through the birth canal.
Broken bones and bruising can occur from physical stress on the face or body during birth. They can also be caused through forceps delivery which can leave lacerations and bruising on the baby. Bones can also be broken due to an excessively forceful assisted birth. In rare occasions injuries can be due to a baby being dropped.
Subconjunctival Haemorrhage shows as a bright red band around the iris and is caused from tiny blood vessels in the eye breaking, usually due to pressure. They do not cause permanent damage and should heal within a few days after birth.
Brachial Plexus Injury is damage to the nerves that connect the arms and legs to the spinal cord. This results in Brachial palsy where the injury limb cannot be rotated or flexed by the baby. This usually only occurs in difficult births where the doctor has had to tug on a limb to get the baby out. If the nerves are stretched or bruised, this can heal within a month or two and may require some physical therapy. Serious injury to these nerves can result in permanent nerve damage.
Bell’s Palsy is a facial paralysis due to damage to the facial nerve during birth or through forceps delivery. The facial muscles on the injured side of the face do not move, which is noticeable during crying or sleeping (one eye remains open). Minor damage to the nerve such as bruising will heal without treatment. Severe injuries may require surgery.
Oxygen Deprivation (Anoxia) can lead to a number of problems for the newborn baby. Anoxia can occur when the umbilical wraps around the babies throat or if the placenta separates prematurely resulting in a reduced flow of oxygen to the brain. This can lead to cerebral palsy which is a neuromuscular condition affecting posture, movement and muscle tone. If baby does not breathe independently after birth for 3 or more minutes, this can also result in brain damage. This can result in seizures, coma and death if baby isn’t transferred to life support in time. Oxygen deprivation can also result in blindness, hearing impairment, learning disabilities and other complications.
Fractures are the most common birth injuries and most often affects the collarbone which is usually caused during a breech delivery or shoulder dystocia. There will be some pain and baby will not be able to move the arm on the affected side very well. This is usually treated with a soft bandage or splint to prevent movement until the injury heals.
Most birth injuries are minor and very little medical intervention is needed. Babies will heal on their own within a short period of time and have very few or no complications as a result of the trauma. It is only in severe cases that there is long lasting injury or long term complications. In these instances, medical intervention may be required on an ongoing basis. Most birth trauma can be avoided by using proactive methods such as ultrasounds to check position of the baby prior to labour and birth. If you have any concerns, talk to your healthcare provider. Good health and regular pre-natal care will go a long way to mitigate the risk of trauma during labour and birth.