After completing graduate school and settling down as an office clerk, Wendy Myers, 35 decided it was time to begin motherhood. After the holiday season, Wendy and her husband David, went down to the local obstetrician for a checkup and they expressed their interest in having a baby. It was later that year that Wendy learned she was pregnant with twin girls. The couple shared the news with friends and they all were over excited to hear the great news that Wendy and David were going to have beautiful twin girls. As the pregnancy moved into the second trimester, the doctor wanted to see her weekly to check on the babies. Wendy was a thin and attractive woman and her small build limited the already crowded space in her belly.

During her eighth month she had begun to show signs of preterm labor and the doctor requested to see her twice a week. She had already taken leave from her job and it was in her thirty third week that she was in full labor. Both babies were safely delivered and remained in the NICU for a little over two weeks. David and Wendy went to pick up Jillian and Mary Myers and they went straight to the local pediatrician for their first checkup. The doctor noticed that Mary tended to have her neck slightly leaned to the right. The couple was explained that Mary had a condition called torticolis or better known as Congenital Muscular Torticollis (CMT). The pediatrician explained to them what is torticollis and how is it treated. It was due to the crowded environment that one of the twins sustained a birth injury which compromised one of the sternocleidomastoid muscle in the neck. While David watched Jillian at home, Wendy took Mary for manual therapy to build up the the muscle. After 3 months of therapy there was no longer any tilt in Mary’s posture.

Birthing injuries are quite common when babies are born. During labor both mother and baby undergo a battle of life. When there are twins the battlegrounds is cut in half which can result in a higher rate of a birth injury. Often there will be multiple obstetricians which will work with a team of pediatricians when twins are delivered to shorten the time of labor. The longer the delivery stretches out the greater the risk is for one of the babies to get injured. Bellow we will discuss various types of injuries which can be caused by a pregnancy and labor.

Infant Torticollis

Torticollis in babies can be caused through the use of forceps or vacuum extraction when doctors use birth assisting tools which unintentionally can result trauma at birth. This can create a weakness in the sternocleidomastoid muscle which will cause the baby to habitually lean towards one side. Neck torticollis can also result prior to labor due to the baby being breached or spine misalignment. In most cases a pediatrician can diagnose by seeing the baby tilting its head towards one position.

Brachial Plexus Injuries (Erb’s Palsy)

Brachial plexus is an injury which is generally localized to the nerve area in a person’s shoulder. It can occur after an injury compromises the shoulder leading to nerve damage. Brachial plexus is most common in adults after a fall or sports injury to the shoulder. For babies it can occur during childbirth in which there is a high level of trauma to the shoulder region. Types of treatment for babies include physical therapy which soften up the muscles allowing the nerves to heal properly. What also comes along with brachial plexus is pain which is often treated with basic pain medication. Shoulder soreness can last several weeks or months depending on how bad the injury was.

Broken Thigh Bone

A broken thigh bone or femur fracture is another type of birthing injury which can be caused by poor positioning of the baby or mother while in labor. The babies lower body gets into a position where its bones are exposed to trauma which results in a sprain or breakage. Infants zero to eighteen months old can be treated with Bryant’s traction and spica cast. Bryant’s traction is an orthopedic cast which allows the bone to heal in an upright position at a ninety degree angle. A spica cast is a complete cast which is worn from the belly down which does not allow for any lower body movement. Once the cast is removed the baby may require physical therapy for the lower body area.

Cerebral Palsy

Cerebral palsy (CP) in newborns occurs when the baby is denied oxygen during labor which results in a brain injury. Causes include lengthy deliveries in which the baby is in the birthing canal for an extended period which cuts off oxygen to the brain. Cerebral palsy in babies can present itself in a variety of ways which include developmental delays, facial muscle weakness, poor motor functions, and pretty much anything associated with the cerebrum. Unfortunately, CP cannot be eliminated entirely, however it can be managed through orthopedic surgery, and occupational and physical therapy.

Cephalhematoma

Cephalhematoma is made up of two words, “cephal”, which means head, and “hematoma”, which refers to a blood hemorrhaging or a blood clot. Cephalhematoma occurs in under two percent of births where there is trauma to the head by either a birth-assisting tool or outside object. Blood vessels crossing the periosteum are then ruptured which causes causes a clot in the skull. It may sound dangerous but is classified as a rather minor birth injury and often can heal by itself.

Perinatal Asphyxia

Similar to cerebral palsy, perinatal asphyxia or birth asphyxia is again caused by the lack of oxygen to the baby during labor and delivery. However, instead of effecting that baby’s brain it affects its blood. We all know that one of main components which is found in blood is oxygen. The red blood cells or RCB, carry oxygen to important organs like the lung and heart. Low oxygen levels during birth can compromise blood efficiency which can result in a baby having a pale appearance, heavy breathing, sizeurs, coma, or even shock. If asphyxia is addressed prior to birth, doctors will give extra oxygen to the mother during labor or default to Caesarean section. Once the baby has been born and it’s now a condition referred to as birth asphyxia, the newborn will be treated with oxygen ventilation until the conditions subside.

Spinal Cord Injuries

When doctors need to come on to birthing tools like forceps it may compromise the babys back resulting in a spinal cord injury. During the delivery the baby’s body which is not fully developed is exposed to outside elements and even the slightest mishap can result in chronic damage. Damage to a baby spinal cord is the most severe birth injury be it that treatment is limited. If doctors identify the damage right away it can treated with medication, and surgery to reduce the impact of injury. More often than not little can be done and the child will need both physical and occupational therapy to develop basic motor skills.

Know Your Legal Rights

It’s important for a patent to know their legal rights if they or their child has been the result of a birthing injury. Someone is required to take the responsibility and more often than not you may be entitled to compensation. However it’s important to note that fighting a legal battle requires time and can take a toll on a person’s lifestyle especially when caring for a child with specific needs. After going through a long pregnancy and recovery, a legal battle is the last thing you need. One can bring in a third party or family member and give them consent to be an advocate on your behalf which may take part of the legal burden off your back. Always keep in mind that you and your baby had an injustice done and the hospital or doctor should take accountability.

Final Words

Labor and delivery is an experience we often take for granted, not fully grasping the complicated environment in which both mom and baby reside. Since 1990 the maternal death rate has decreased by over 50% and is on target for an even further reduction. In regards to newborn deaths the rate has decreased by over 150% since the year 1900. Childbirth during the nineteenth century was a near death experience. If at best you had a midwife which did not have any pediatric schooling. When there was a post birth emergency someone would have to fetch the local pediatrician. This took up vital seconds where life and death was in the balance. Much has changed and doctors are taking less risks where a delivery involves any danger to the mother or baby. As the pregnancy goes into the third trimester, doctors can detect issues via an ultrasound and know what to anticipate at birth, begin well prepared for delivery. Cesarean sections are on the rise which often results in a healthy mother and baby. Though woman hate the to have the scar of labor they are often satisfied with a safe outcome.