Warning Signs of a Birth Injury

Our San Antonio Lawyers Discuss Signs Your Newborn, Infant or Toddler May Be Affected by a Birth Injury

Birth injuries, a form of medical malpractice, may occur at four different points: during pregnancy, during labor, during delivery and birth, or after the birth of the child. Concerned parents often ask us whether an injury qualifies as medical malpractice or negligence by a doctor, nurse, pharmacist, hospital, birthing center or other medical professional.

The answer is rarely obvious and straightforward; babies are born with very flexible and soft bones, designed that way in order to travel through the birth canal. Injuries are fairly common in the birthing process and occur to both the mother and child, especially for vaginal delivery.

Determining the difference between a minor injuries, a major injury, and an injury caused by medical malpractice is difficult, especially for new parents. The medical legal experts at Grossman Law Offices have created a list of common signs and symptoms to watch for during pregnancy, labor, delivery, and birth of the child based on our experience with birth injury legal cases. Many of these signs correlate with serious and birth injury malpractice cases, but we have also included signs and conditions correlating with non-malpractice harms or injuries.

Before reviewing this list, remember: trust your instincts. If you believe something went wrong during pregnancy, labor, childbirth, or after the birth of your child, our staff can investigate for you. Call Grossman Law Offices for your personalized and confidential review of your situation. Call 1-855-393-0000 (toll free) now to speak with our birth injury attorneys and our medical legal team.

Normal Newborn Birth Injuries

• Small White Cysts: diagnosed as milia, these little white pimple-like cysts may appear across a newborn’s face, along the bridge of the nose, cheeks and forehead. These are merely clogged sweat glands and will clear up on their own in a matter of a couple of weeks.
• Pink Marks: sometimes referred to as “stork bites,” these pink marks may be visible on the forehead, neck, eyelids, and face. These are birthmarks and are pink because they are dilated, blood-filled capillaries. Often these birthmarks fade with age; by the time your toddler is two or three years old, they will be barely visible.
• Bruising: babies are often born with bruises along the scalp, forehead, nose and neck. These bruises are part of the natural birthing process, due to the head and face forcing a tight birth canal to open fully. Babies may also appear malformed (pointy-headed), again due to the pressure of the birth canal and the rubbery bones of the skull and shoulders. Pointy heads generally reshape themselves within a couple months as the baby grows and the skull becomes harder. Bruising or any accompanying swelling typically clears up within a few days to a week.
  • Abnormal Bruising or Head Shape: If your child was born with a large bruise on top of skull or if there are strange lumps or depressions in the skull bone, this is a sign of a serious brain injury. Your child will need to be closely monitored for several days and may undergo several medical procedures to reduce swelling, correct any chemical imbalance, or prevent blood hemorrhages or clots.
• Broken Bones: newborns with broken collarbones (broken clavicle) are rare, but don’t usually suggest birth injury medical malpractice. However, if an arm, leg, or shoulder is broken, this can be a early warning sign for long-term effects from a birth injury due to malpractice.

Signs of an Abnormal Pregnancy & Resulting Birth Injury

One major sign of an abnormal pregnancy and resulting birth injury is simply one of poor doctor care, diagnosis and treatment throughout your pregnancy. Each pregnancy is special and unique and should be treated as such by your prenatal doctors, obstetrician or birthing experts. Medical malpractice may result from a lack of case if:

• Your doctor, obstetrician (OB) or other medical professional did not adequately track, treat, or warn you of existing or developing maternal medical conditions conditions such as preeclampsia, hypertension, RH negative disease, gestational diabetes, strep B, early labor, or other pregnancy related conditions.
• Your doctor, obstetrician (OB), or other medical professional did not adequately track, treat or warn you of any fetal complications or dangers arising during your pregnancy, and a dangerous complication results. This includes any medicine or drug side effects and their effect on your baby, any type of fetal distress, ectopic pregnancies, toxoplasmosis, along with several other possible conditions.

Common medications that affect developing babies during pregnancy are often prescribed for depression, skin conditions, asthma, diabetes, nausea, and gastrointestinal (GI) disorders. Effects of these medications may vary, but often result in developmental delays, organ failures, retardation, disfigurement, and even death. Medical professionals, including doctors, nurses, and pharmacists have a duty to adequately warn a mother of these effects while she is pregnant, and either discontinue treatment or find a way to mitigate the effects of these drugs on the developing baby.

Signs of an Abnormal Labor and Delivery & Resulting Birth Injury

When a pregnant mom-to-be enters the hospital or birthing center in labor, the first thing that needs to happen is for her to be hooked up a dual set of monitors to check on the vital signs of the mother and soon to be born baby. Delays by nurses, technologists, and other medical staff in hooking up the monitors can quickly result in a serious birth injury. Delivery teams that go one step further and disregard any data from the monitors, both for the mother and the child, are risking serious birth injury as well. Not paying attention to fetal or maternal distress, usually known by an abnormally high or low heart rate, abnormally high or low blood pressure, or abnormally high temperatures often leads to serious birth injuries with life-long results and harms. These birth injuries may not be immediately evidence at birth, but developmental delays within a few weeks to months will show that a birth injury did occur.

At the time of delivery, several major problems may arise. Signs include:

• Abnormal positioning of the baby. This is often seen via ultrasound before delivery and can be the deciding factor as to whether to proceed with a cesarean section (c-section) delivery or a vaginal delivery. If the doctor fails to perform an ultrasound or disregards the value of the ultrasound, a birth injury is likely to result. This can be a form of medical malpractice as well as an ultrasound is an easy, quick way to prevent an unnecessarily dangerous delivery.
• An abnormally large baby or an unusually small birth canal is a major warning sign for obstetricians attempting a vaginal delivery. Simple physics dictates that the bigger the object, the less likely it will be able to pass through a small, tight canal, instead getting stuck - and leading to serious injury. The delivery team are there to monitor the progress of the birth and to guide the mother through the birth and the baby out of the birth canal. Pushing or pulling on the baby’s head or neck to get the child out of the birth canal risks very serious injury to both the mother and child. These deliveries are much safer as cesarean section (c-section).
• Use of instrumentation to force the baby through the birth canal is a major warning sign for birth injuries. Often, instrumentation is used in cases of shoulder dystocia, or when the baby’s shoulder is lodged in the birth canal and the baby is stuck. These situations may not necessarily point to medical malpractice - but if the baby is just taking his or her time coming out, and the doctor decides he or she is done waiting, any injuries that result may be medical malpractice. Common instrumentation include forceps and vacuum extraction. Safer doctors opt for c-sections in these situations rather than risk harm to the baby or mother. Risks for the use of instrumentation include injury to the brain, neck, spinal cord, and nerves in the shoulders, as well as blot clots and hemorrhaging in the head and brain.

At the birth of the child, signs and symptoms of possible serious birth injury include:

• Asphyxia (no oxygen in the blood) - the baby will appear pale in color, lifeless-looking, weakly breathing or not breathing at all, and a slowed heart rate. Depending on how long the baby went without oxygen will determine the extent of brain and organ damage sustained. APGAR scores typically correlate with the severity of injury, though the child should be closely monitored by medical personnel for up to a week following birth. Asphyxia as a medical malpractice injury usually occurs when the umbilical cord is constricted during the birthing process, often seen on fetal monitors during labor and delivery. Asphyxia may also occur with a botched epidural performed during labor, another medical malpractice mistake.
• Hypoxia (too little oxygen in the blood) - the baby will appear blue in color, weak or no breath patterns, with an increased heart rate, suggesting brain injury. Hypoxia is often seen in later diagnosis of cerebral palsy and other brain developmental disorders, including delayed muscle development, delayed nerve development, possible retardation, and serious long-term care needs.
• Low APGAR scores - an APGAR score assesses the basic health of baby at the time of birth and is based on a 1-10 scale. This score is determined across five basic characteristics and calculated at the time of birth. Scores less than 6 mean the baby needs immediate medical attention. At later intervals, the scoring process is repeated, usually at three, five, then, and fifteen minutes after birth to fully determine the baby’s basic health post-birth. A score less than five at these intervals typically correlate with long-term brain damage, a risk for retardation and delayed development, and in many instances, may lead to a later diagnosis of cerebral palsy or other developmental disorders.

After the birth of the child, signs and symptoms suggesting birth injury malpractice include:

• The child is sluggish or lethargic and exhibits asymmetrical movements in the face, arms, or legs. Often parents describe their child as looking out of only one eye, showing half-smiles, or strictly favoring one side of the body more than the other.
• The child has little to no interest in feeding or exhibits problems with instinctual feeding mechanisms such suckling and grappling, but has no problem attaching to a nipple.
• The child shows signs of seizures, including a constant sucking or tongue movement, tense and rigid body followed by uncharacteristic jerks, glassy eyes, rapid eye movements, and unusual brain activity.

Long Term Signs and Symptoms of Birth Injury Malpractice

Despite signs or symptoms of birth injuries at the time of birth, most long-term birth injuries are not diagnosed immediately at or following birth of the child. Most doctors wait until the child show signs of developmental delays in order to gauge the depth and severity of the original injury and resulting condition. Usually these diagnoses are for lifelong developmental conditions, such as cerebral palsy, Erb’s palsy, or other neurological or brain injuries. Additionally, doctors tend to defer when asked “how did this happen?” or “where did this come from?”, telling new parents that there is no single cause. Instead, doctors spend their time with families focusing on various therapies and special technological accommodations and adaptations for the child, and outline the long-term care and education the child will require for the rest of their life.

A full review of the pregnancy, labor, delivery, birth, and resulting treatment of both mother and child is essential to answering the question “why did this happen” - and determining whether any injury and resulting harms were preventable by medical staff at any point along the way. A knowledgeable San Antonio birth injury attorney and medical legal review team can investigate your personal situation surrounding your child’s injuries and provide you and your families answers and options with how to proceed following any injuries and resulting long-term diagnosis.

Call the experienced San Antonio birth injury case team at Grossman Law Offices at 1-855-393-0000 (toll free) for more information about any suspicions regarding the pregnancy or birth of your child. We can provide you answers, options, and help you and your family receive any compensation your family deserves as a result of birth injury medical malpractice.