Brachial Plexus Injuries at Birth

Brachial Plexus Injuries at Birth

The brachial plexus is a network of nerve fibers that runs from the neck to the arm. A newborn baby can suffer a brachial plexus injury during birth if a physician or midwife uses excessive force during delivery. One common cause of brachial plexus injuries at birth is the setting of a “shoulder dystocia” also known as a “trapped” shoulder.

Shoulder Dystocia and Brachial Plexus Injuries

A shoulder dystocia can occur during birth when the baby’s shoulders reach the birth canal in an awkward position. Usually, when a shoulder dystocia occurs, the baby’s shoulders are in a straight up and down position rather than an angle. The upward facing shoulder of the baby becomes stuck on the mother’s pubic symphysis, which is the cartilage that connects the right and left pelvic bones, and prevents delivery of the baby after the baby’s head has emerged.

To resolve the situation, a doctor or midwife may pull the baby in a down and out direction, but if excessive force is used the brachial plexus can be stretched so much that nerve tearing can occur. As explained by birth, the mechanics are similar to someone sitting on a person’s shoulders so that the person’s body cannot move while another person pulls the person’s head away from their shoulders.

A brachial plexus injury caused by shoulder dystocia can be a legally actionable birth injury because medical professionals are taught to never pull on the head of a baby when setting a trapped shoulder. Proper prevention of the birth injury can be accomplished by lowering the occurrences of shoulder dystocia or delivering the baby without pulling the head.

Why a Shoulder Dystocia Is an Emergency

The occurrence of a shoulder dystocia during birth is a medical emergency because the supply of oxygen to the baby is reduced when the baby’s head is outside of the mother’s body and the remainder of the baby’s body has not been delivered. During such circumstances, brain damage can occur, and generally, only 10 to 15 minutes can pass in between the delivery of the head and the shoulder before brain damage occurs.

Medical professionals are also taught how to properly handle a shoulder dystocia during birth. To resolve the trapped shoulder a doctor should rotate the baby to a position where the baby’s shoulders are at an angle. Medical staff accomplishes the rotation of the baby by putting the mother in a position where her legs are flexed back towards her chest. Suprapubic pressure is then applied below the belly button to move the shoulders of the baby into an angle.

Risk Factors for Shoulder Dystocia

There are common risk factors for shoulder dystocia. The common factors are:

  • A large baby
  • A small or misshaped pelvis
  • Excessive weight gain by mother
  • Gestational diabetes
  • Slow dilation
  • Short maternal stature
  • Use of forceps or vacuum extractor
  • A shoulder dystocia at a prior birth
  • A brachial plexus injury at a prior birth

If you believe your child suffered a birth injury, contact an experienced personal injury attorney to review your legal options.