Birth injuries: causes,
types & legal help

What is a birth injury?

Birth injuries are trauma suffered by newborns around the time of delivery. While some will heal in the first year on their own, many require a lifetime of medical care. Those that are permanent often affect a child’s brain function or ability to move.

Upon examining birth records, experts often find that mistakes by doctors or hospital staff contributed to a child’s injury. In these cases, families have a legal right to seek compensation to help cover damages. Birth injury lawsuits often reach amounts in excess of $1 million and can be the primary source of funding for a child’s lifetime care.

If you have questions about your child’s birth injury or whether mistakes were made during delivery, our lawyers and nurses are available to speak with you today at no charge.

Types of birth injuries

While babies are at risk for countless types of birth injuries, some occur far more often as a result of delivery trauma. They are broadly classified into four main categories: nerve and spinal cord damage, brain damage, swelling and hemorrhaging, and broken bones.

Nerve and spinal cord damage

Babies may become stuck passing through the birth canal due to breech positioning or shoulder dystocia. The use of excessive force during such deliveries can damage the nerves running through the spine or shoulder, causing partial or full paralysis:

A brachial plexus injury damages the bundle of nerves running from the neck into the shoulder, arm and hand. Where the upper part of that bundle is affected, the result is Erb’s palsy: an arm held limp against the body, with passive range of motion exceeding what the baby moves on their own. It occurs in about 1.5 per 1,000 total births. Facial paralysis is the other common nerve injury, caused by pressure on the cranial nerve, and it is most often associated with forceps.

Brain damage

The brain requires the highest percentage of oxygen of any organ. Delays or complications during delivery that temporarily disrupt oxygen flow can result in brain cell death. Brain damage may also be caused by severe untreated jaundice (kernicterus). Examples include:

Cerebral palsy is the most common movement disorder caused this way, and it is an outcome rather than a mechanism. What produces it varies, and the pattern on imaging says which. Periventricular leukomalacia, white matter damage around the ventricles, was the most frequent finding in a systematic review of MRI in cerebral palsy at 56%, and it turned up in 90% of preterm-born children against 20% of those born at term. Grey matter injury ran the other way, 33% in term births against 3.5% in preterm.

Hypoxic-ischemic encephalopathy is the term for the brain dysfunction that follows oxygen deprivation at term, and it is the one that carries a treatment window. Intraventricular hemorrhage, bleeding around the brain from fragile or damaged vessels, is largely a complication of prematurity. Cerebral dysgenesis is different in kind: the brain formed abnormally early in pregnancy rather than being injured during delivery, which matters for what caused it and for what follows.

Swelling and hemorrhaging

Bleeding around the brain or swelling of an infant’s scalp may occur as a result of trauma from delivery tools, pressure from delayed birth, or undeveloped blood vessels in preterm birth:

• Cephalohematoma — often caused by birthing tools such as vacuums or forceps, causing rupture of blood vessels and bleeding under the scalp
• Caput succedaneum — cranial swelling caused by undue vaginal or uterine pressure on the scalp during a prolonged delivery or from birthing tools
• Intracranial hemorrhage — bleeding inside the brain, usually occurring in preterm births due to unformed blood vessels

Broken bones

Collarbone fractures are the most common bony birth injury, and they matter here for a reason that has nothing to do with the bone. A fractured clavicle produces an arm the baby will not move, which imitates a brachial plexus injury exactly, so one has to be excluded before the other is diagnosed. The fracture itself almost always heals without intervention.

What’s the difference between a birth injury and a birth defect?

Although these terms are often used interchangeably, birth defects and birth injuries have different causes and times of occurrence. The distinction matters significantly for families exploring legal options.

Key differences

Birth injuries are trauma to a baby that occurs around the time of delivery, or just afterward. They are often the result of delivery complications, tool misuse, oxygen deprivation, or excessive force. Examples include nerve injuries, brain damage from oxygen restriction, and head trauma.

Birth defects typically occur much earlier, during the first few months of pregnancy. They are often identified before birth during prenatal testing and can be linked to nutrition deficiencies, infections, toxic exposure, or chromosomal issues.

The critical distinction: a large percentage of birth injuries are caused by mistakes from medical professionals. When this occurs, the family of the victim has the legal right to seek compensation. Birth defects generally do not carry the same legal basis for a claim.

Signs and symptoms of a birth injury

In many cases it can take a year or more for the symptoms of birth injuries to become noticeable. However, there are early signs parents can look for in the first year that may indicate a problem.

Early signs in infants (under 12 months)

• Seizures
• Trouble breathing
• Stiff muscles or lack of muscle tone
• Excessive drooling
• Reduced heart rate
• Difficulty feeding or swallowing

Although the presence of these signs doesn’t absolutely confirm a birth injury, it’s important to notify your doctor and schedule a screening promptly. Early detection is crucial for effective treatment.

Signs in toddlers (over 12 months)

As children grow beyond the first year, symptoms of a birth injury often become more apparent, typically presenting as failure to meet normal developmental milestones:

• Hearing or vision problems
• Muscle spasms or tremors
• Slow speech or language development
• Trouble sitting up or balancing
• Delayed crawling or walking
• Difficulty touching mouth or eating
• Problems grasping objects

If you notice any of these signs, contact your doctor for a health screening as soon as possible. Learn more about specific cerebral palsy symptoms and how CP is diagnosed.

Birth injury statistics 2026

The most up-to-date statistics on birth injuries show that while the overall occurrence trend is declining, there is still a long way to go with improving newborn safety and delivery practices in the U.S.

• 25,000+ Babies born with a birth injury each year in the U.S.
• 7 Newborns with moderate or severe HIE who need cooling to prevent one death or major disability (Cochrane, 11 trials)
• 1.6 per 1,000 Live births with potentially avoidable birth trauma to the newborn (AHRQ, 2006 data)
• 1 in 345 Babies are diagnosed with cerebral palsy, the most common birth injury movement disorder
• 10–20 per 10K Babies suffer a brachial plexus birth injury, often from difficult delivery
• 59 per 10K Vacuum-assisted deliveries result in a birth injury
• 33% higher Birth injury rates in the most rural U.S. areas compared to large cities
• Declining Overall birth injury occurrence rates in the U.S. have decreased in recent decades, improved care is working

Cerebral palsy is the movement disorder these deliveries most often leave behind, and it is counted separately. Prevalence by age and race, the split between the five types, walking and communication rates, and lifetime cost are collected in our statistics on cerebral palsy.

Causes of birth injury

Distress during delivery is what most of these injuries have in common: due to a combination of physical trauma, oxygen deprivation, or medication toxicity. While some have natural causes present before delivery, a large number might have been prevented without mistakes made by hospital staff or doctors.

Asphyxia, meaning a loss of oxygen or blood flow, sits behind the most serious outcomes. It can follow infection, an obstructed umbilical cord, placental separation, maternal illness, or simply organs too undeveloped to manage in a preterm infant. Physical trauma is the other broad route: misused delivery instruments, or force applied to free a shoulder or manage a breech position, reaching the skull, nerves, bones or spinal cord.

Three narrower causes account for much of the rest. Labor lasting beyond about 20 hours adds sustained stress to the skull and spine and raises the chance of asphyxia. Labor-inducing medication such as Pitocin can produce fetal distress when contractions are driven harder than a baby tolerates. And meconium aspiration, where a distressed infant inhales fetal stool and amniotic fluid, can obstruct the airway and seed a lung infection.

Distinguishing a natural cause from a preventable one is rarely possible from the delivery story alone. If a child was injured during a prolonged or complicated delivery, the records are what answer the question, and they are worth having reviewed by someone who reads them for a living.

Can birth injuries be prevented?

No one can guard against all uncertainties during pregnancy and delivery. However, understanding the risk factors for birth injury can help parents and care teams plan for the healthiest possible delivery. According to the National Institutes of Health, risk factors are grouped by their link to delivery tools, the fetus and pregnancy, or the mother.

Promoting prenatal health

Those factors are worth knowing and they are poor predictors. The American College of Obstetricians and Gynecologists task force on neonatal brachial plexus palsy found the injury described in the literature occurring without any clinically recognizable shoulder dystocia, at both vaginal and cesarean delivery, which is a plain statement that screening does not identify the affected births in advance.

What has been shown to work is preparing the people in the room. One UK hospital delivering around 6,000 babies a year introduced a training day including a 30-minute practical session on shoulder dystocia, and researchers compared the twelve years that followed against the four before. Use of a recognized resolution maneuver rose from 46.3% of cases to 99.8%. Brachial plexus injury at birth fell from 7.4% to 1.3%, and in the 562 cases of shoulder dystocia in the late period, none of the injuries lasted beyond twelve months.

Alongside that sit the ordinary things an expectant mother controls: attending scheduled prenatal visits, taking supplements, keeping blood glucose managed where diabetes is present, avoiding tobacco and alcohol, and raising concerns rather than sitting on them.

How are birth injuries diagnosed?

While some birth injuries are identified immediately after delivery, others may not become apparent until months or years later when developmental delays become noticeable. Several diagnostic methods are used to detect and confirm birth injuries.

Neuroimaging tests

MRI shows the injury and dates it. Periventricular leukomalacia, the white matter damage most associated with preterm birth, and the deep grey matter pattern that follows severe oxygen deprivation at term look different from each other and point to different timing. A systematic review found abnormal MRI in 334 of 388 children with cerebral palsy, 86%, with the pattern indicating when the injury occurred in 83% of them. CT is the fallback where MRI is unavailable, at the cost of radiation and detail.

Apgar score

The Apgar test measures a newborn’s heart rate, breathing, muscle tone, reflex response, and skin coloration immediately after birth. Lower scores can indicate potential health issues requiring further evaluation.

Umbilical cord blood gas analysis

This test evaluates oxygen and carbon dioxide levels in an infant’s blood immediately after delivery. It can reveal signals of oxygen deprivation linked to brain damage, providing critical early evidence.

If you have concerns about your child’s development or a possible birth injury, schedule a screening as soon as possible. Our experienced nurses are also available to discuss your child’s case and provide guidance on next steps.

Treatment options for birth injuries

Every child’s treatment needs following a birth injury are unique. Some may only require periodic monitoring, while others need extensive lifelong care. The goal is always to maximize independence, manage symptoms, and improve quality of life.

Cooling, and why the first six hours matter

One birth injury treatment runs on a clock. Where a term newborn shows moderate or severe hypoxic-ischemic encephalopathy after oxygen deprivation around delivery, lowering the body temperature by a few degrees for 72 hours changes outcomes. A Cochrane review of 11 randomized trials covering 1,505 infants found therapeutic hypothermia cut the combined outcome of death or major neurodevelopmental disability at 18 months, with a risk ratio of 0.75 and a number needed to treat of 7. Mortality alone fell with a number needed to treat of 11.

The window is narrow, generally within six hours of birth, which makes recognizing encephalopathy quickly part of the treatment rather than a preliminary to it. It is also why the timing recorded in a delivery and nursery chart carries so much weight afterwards.

Therapy

Therapy is frequently the first line of treatment for birth injury symptoms. Occupational therapy works on the tasks a child needs their hands for, and on the equipment that makes those tasks possible when the hands alone will not do it. Speech and language therapy assists those with communication challenges from brain damage. Physical therapy manages and relieves muscle stiffness, improves coordination, and targets mobility goals like walking and wheelchair use. Recreational therapy uses outdoor activities like swimming and horseback riding to build strength and improve quality of life.

Assistive devices and adaptive equipment

Scooters, wheelchairs, crutches, braces, and gait trainers can significantly help children with mobility difficulties gain independence. Adaptive utensils, cups, and dressing aids assist those with fine motor limitations. Communication boards and voice output devices support children with speech or language challenges.

Medications

Depending on the specific effects of a birth injury, a pediatrician may prescribe medications to promote recovery or manage symptoms. For brachial plexus injuries like Erb’s palsy, Botox may be used to incapacitate select muscle groups and force use of weaker muscles during therapy. For cerebral palsy, anticonvulsants, muscle relaxants, and nerve blocks may be prescribed to manage seizures, reduce muscle contractions, and decrease chronic pain.

Surgery

For children with severe birth injuries where therapy and medication provide insufficient relief, surgery may be an option. For Erb’s palsy, microsurgeries, joint release, and tendon transfers may improve strength and range of motion. For cerebral palsy, osteotomy to realign bones, spinal surgery for scoliosis, or selective dorsal rhizotomy for spasticity may provide lasting relief. Most insurers require therapy and medication trials before approving surgery.

Many families find that insurance and financial assistance aren’t enough to cover the expense of ongoing birth injury treatment. Compensation from a birth injury lawsuit can be crucial to funding lifetime care.

Birth injury caused by medical mistakes

A federal analysis of 2006 hospital data found nearly 157,700 potentially avoidable injuries to mothers and newborns during childbirth in a single year; 8,877 of them were injuries to the newborn. When medical professionals fail to meet the standard of care during delivery, it can be considered negligence or medical malpractice in all states.

The mistakes that produce these cases cluster into two kinds. One is doing something wrongly: excessive force during delivery, or careless use of a vacuum extractor or forceps, which reaches nerves, bones and the skull. The other is failing to do something in time, and that is the larger category. Fetal monitoring that nobody watches. Warning signs of oxygen deprivation or an abnormal heart rate that get recorded and not acted on. A maternal or fetal condition missed. A cesarean that was indicated an hour before it was performed.

Timing is why the second kind matters so much. Cooling for hypoxic-ischemic encephalopathy has to start within about six hours of birth to work, so a delay in recognizing the encephalopathy does not just postpone treatment, it can remove the option. That is also why the times written in a delivery and nursery record carry the weight they do when a case is reviewed afterwards.

When medical mistakes result in birth injuries, families have the right to seek compensation for medical care, therapy, life-care, and pain & suffering. A CDC study put the average lifetime cost of cerebral palsy at $921,000 per person in 2003 dollars, about $1.7 million today. Our birth injury lawyers are available 24/7 to discuss your case at no cost, and there is never a fee unless compensation is recovered.