A physician or midwife's excessive force during the delivery of a baby can cause shoulder, arm and hand injuries. This is known as a brachial plexus injury. These injuries can result in a limp or paralyzed arm, lack of muscle control in the arm, hand or wrist or a lack of sensation in the arm of hand.
How Does the Injury Occur?
When an infant's shoulders come through the birth canal in an unusual position, the top shoulder can get wedged in the birth canal. This is known as "shoulder dystocia." A doctor or mid-wife usually apply traction in a downward or outward direction to pull the baby free. The force used to pull the baby free can damage the brachial plexus nerves.
Doctors and midwives know that pulling out a baby's head is not a standard procedure because of the potential for catastrophic injury. However, shoulder dystocia can still occur if certain factors are present such as:
- A large baby, a small pelvis or short maternal stature. A baby over 8 pounds and 13 ounces has an increased chance for shoulder dystocia. Likewise a mother with a small pelvis or a short stature is at increased risks.
- Mother's excessive weight gain or gestational (maternal) diabetes. Weight gain of more than 30 pounds and gestational diabetes corresponds to larger baby size and a higher risk of shoulder dysocia.
- A prior delivery with shoulder dystocia or brachial plexus injury. A prior delivery with complications increases the risk of shoulder dystocia and brachial plexus injury. Cesarean section should be used in subsequent deliveries.
- Slow dilation. Any abnormalities in dilation or descent indicate the baby is a tight fit and at a heightened risk of shoulder dystocia.
- Use of forceps or vacuum extractor. These instruments do not shift the baby's position in the birth canal, interfere with the delivery process by pulling the baby straight down and increase the chance of shoulder dystocia.
Birth injury attorneys say that each case is different and the severity of the injury is determined by the damage done to the nerves. Treatment for brachial plexus injuries includes physical therapy and possibly surgery. If you believe excessive force of negligence by a health care provide may have caused your infant's injuries, contacting a birth injury attorney is recommended.
