Birth Injury - Brain Damage at Birth

Approximately 20% of injuries that cause cerebral palsy happen near the time of birth. While many birth injuries are unavoidable, some may be preventable.

How Birth Injuries Occur

Damage to the developing brain before, during, or after birth causes cerebral palsy. Birth injuries refer to damage that occurs during labor, delivery, or shortly after delivery. Most birth injury cases happen before babies are born, but a small percentage of injuries take place in the delivery room.

Types of Birth Injuries

A birth injury that causes cerebral palsy can come in many forms. There are several risk factors that increase the likelihood of a physical injury occurring.

Some of these factors include:

  • Infections
  • Oxygen deprivation or blood flow to the baby’s brain
  • Blood clotting
  • Placental abnormalities including poor perfusion or abruption
  • Maternal high blood pressure
  • Improper medical care
  • Prenatal drug use
  • Premature birth or low birth weight
  • Multiple gestation
  • Injury to the brain

Factors that Increase Birth Injury Chances

There are four basic types of brain damage that result from birth trauma. Understanding these factors can help explain how damage to the developing brain can cause cerebral palsy.

Hypoxic ischemic encephalopathy (HIE) – This is the medical term for brain damage caused by decreased blood and oxygen levels to the brain. This is the leading preventable birth injury affecting the brain. HIE leads to the destruction of brain cells and tissue, predominantly in the motor cortex of babies who develop cerebral palsy. It may occur during pregnancy or delivery. If HIE occurs during pregnancy, it may lead to another type of brain damage, periventricular leukomalacia.

Periventricular leukomalacia (PVL) – This is the death of white matter in the brain and the subsequent loss of brain tissue. White matter contributes to the brain’s ability to learn and function. PVL is specifically caused by a lack of blood flow to the periventricular part of the brain where white matter is found. It is made of nerve fibers that relay signals for motor function. It is caused by loss of oxygen to the fetal brain and can co-occur with bleeding in the periventricular region. Placental failure and infection may cause PVL.

Intracranial hemorrhage – Bleeding in the brain is known as intracranial hemorrhage. The most common cause of intracranial hemorrhaging is fetal stroke. Blocked or damaged blood vessels in the child’s brain can cause a stroke and subsequent hemorrhaging. High blood pressure, complications with the placenta, and infections in the mother may lead to intracranial hemorrhaging. Pelvic inflammatory disease, an infection of the female reproductive system, is a common cause of bleeding in the brain of the fetus. This is most common in premature infants.

Cerebral dysgenesis – Anything that inhibits the healthy development of the fetal or infant brain can cause abnormal development of the motor control center. Cerebral dysgenesis is just a medical term for abnormal development of the fetal brain. This generally occurs during pregnancy when the brain is forming. Direct injury to the baby’s head during or shortly after delivery and infection can also cause cerebral dysgenesis. Infections can mutate the genes responsible for developing motor function.

Preventable Birth Injuries

Some common birth injuries that lead to cerebral palsy are preventable. The source of these cases is often medical malpractice on the part of the obstetrics team.

Preventable birth injuries are usually caused by:

  • Failing to detect infections during pregnancy
  • Adverse effects from drugs or surgery
  • Neglecting proper heart rate monitoring during delivery
  • Not performing a medically advisable cesarean section (C-section)
  • Improper use of delivery instruments, such as forceps
  • Failing to detect issues with the umbilical cord
  • Gross mismanagement of normal delivery procedure
  • Failing to treat severe jaundice in the newborn

These lapses in medical judgment can cause cerebral palsy by inhibiting normal development, depriving the fetus of blood and oxygen or causing physical trauma. Any of these factors can cause damage to the developmental brain.

Forceps and Vacuum Extractors

The use of forceps and vacuum extractors during a difficult delivery can increase the chances of a child sustaining an injury during birth.

Forceps and vacuum extractors come with several risk factors, including:

  • Brain or nerve damage
  • Skull fractures
  • Fetal stroke
  • Seizures
  • Cerebral palsy

The improper use of these birth-assisting tools can lead to cerebral palsy when direct pressure is applied to an infant’s head during delivery. When birth-assisting tools are placed incorrectly, this can result in lifelong damage to the skull, eyes, brain, and facial nerves.

Erb’s Palsy

Erb’s palsy also called brachial plexus palsy, is commonly confused with cerebral palsy due to the various symptoms associated with these forms of paralysis and nerve injury. The most obvious symptom that sets Erb’s palsy apart from other conditions is when the paralysis affects the voluntary movement in the upper arm and rotation in the lower arm.

The cause of this condition can vary, but it typically occurs during a difficult child birth where shoulder dystocia occurs. There are a number of risk factors associated with this condition, and treatment for a brachial plexus injury depends on the severity of the paralysis.

Getting Legal Compensation

Parents of a child whose cerebral palsy was caused by a preventable birth injury may be entitled to legal compensation. Cerebral palsy is a condition that requires lifelong treatment, and the costs of raising a child with CP are many times greater than raising a child without a disability.

Parents have the right to seek compensation through a lawsuit. There are attorneys who are highly experienced in handling cerebral palsy cases. They are able to sift through all the available evidence to determine whether the parents have a strong case. Get connected with an experienced birth injury lawyer for a free case review.

Birth Injury Support Team
kristin proctor registered nurseReviewed by:Kristin Proctor, RN

Registered Nurse (RN)

  • Fact-Checked
  • Editor

Kristin Proctor began her nursing career as a U.S. Army Nurse and has been a Registered Nurse (RN) more than 20 years. She has specialized experience in labor and delivery, as well as prenatal, antepartum, and postpartum care. Kristin uses this experience to educate and support families affected by birth injuries.

Cerebral Palsy Guide was founded upon the goal of educating families about cerebral palsy, raising awareness, and providing support for children, parents, and caregivers affected by the condition. Our easy-to-use website offers simple, straightforward information that provides families with medical and legal solutions. We are devoted to helping parents and children access the tools they need to live a life full of happiness

View Sources
  1. Understanding Cerebral Palsy: A Guide for Parents and Professionals. Marion Stanton. Jessica Kingsley Publishers. London and Philadelphia. 2012.
  2. Cerebral Palsy: A Complete Guide for Caregiving 2nd ed. Freeman Miller, M.D. and Steven J. Bachrach, M.D. The Johns Hopkins University Press. Baltimore, MD. 2006.
  3. Children with Cerebral Palsy: A Parent’s Guide 2nd ed. Edited by Elaine Geralis. Chapter 1: What is Cerebral Palsy? by Dr. Elliot S. Gersh. Chapter 3: Medical Concerns and Treatment by Dr. Gersh. Woodbine House, Inc. Bethesda, MD. 1998.
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