Safe Delivery: How Doctors Can Avoid Birth Injuries

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Last updated May 24, 2017.

The thing you want most as a parent is for your little one to be safe and healthy. During pregnancy, you eat the right foods and take the right supplements to help give your baby the best possible start. Best practices notwithstanding, some children are born with congenital health problems and, unfortunately, there’s not much anyone can do to prevent that. However, some otherwise healthy children suffer injuries during the labor and delivery process that could be prevented with the right care. Doctors aren’t perfect, but there are still ways to increase the odds of a safe delivery for both mother and child.

Childbirth Injuries: Statistics and Causes

Labor and delivery are stressful and sometimes dangerous — childbirth is the sixth leading cause of death in the US for women between the ages of 20 and 34. Over 600 women in our country die each year as a result of pregnancy or delivery complications, with the increase in recent years of mortality rate being driven by heart problems and other medical conditions, like diabetes. It’s dangerous for the baby, too. According to Save the Children, more than one million children die the day they’re born every year and another million are stillborn.

So, what is it that’s so dangerous about childbirth? The leading causes of maternal mortality are severe bleeding, eclampsia (high blood pressure leading to kidney failure, seizures, or coma), and prolonged or difficult labor. Mothers with preexisting conditions such as obesity, diabetes, and cardiovascular disease are at a higher risk for complications that may affect them and the baby, as are mothers who are older than 35 or those having a multiple birth.

See also: Pregnancy after 40: Risks and Safety

Birth Canal Injuries

The most common types of birth injuries for infants are trauma to the head, neck, and shoulders, since most babies are delivered head first. Large babies are more at risk since they have a more difficult time passing through the birth canal. Doctors may use forceps or a vacuum to help the baby through the birth canal, but incorrect use of those tools can cause nerve damage to the face or arms or broken bones (including skull fractures).

Babies also are at risk for asphyxiation during labor if the process doesn’t move quickly enough. They may end up trapped in the birth canal with the umbilical cord compressed, meaning their oxygen supply is cut off. Maternal problems can result in damage to the placenta or umbilical cord, which can also threaten the baby’s flow of oxygen. Oxygen deprivation can cause permanent brain damage, including cerebral palsy.

In other words, babies are at the highest risk of injury if labor is long or difficult. But many of those injuries are preventable — more than 30%, according to the Department of Health and Human Services.

How can birth injuries be preventable?

It’s important to note that some of these injuries are unavoidable. We can’t predict everything that could possibly go wrong during delivery and sometimes there’s simply nothing your health care team could do to avoid an injury to you or the baby. But the number of injuries that could be prevented is simply too high. What’s causing it?

According to studies by the Doctors Company, the largest physician-owned malpractice insurer, more than a third of preventable birth injuries are caused by the “selection and management of therapy.” In other words, the problem is that health care providers either choose the wrong treatment or perform that treatment incorrectly. Common examples include failure to evaluate the size of the baby and assess whether a vaginal delivery is feasible, failure to address complications such as high blood pressure, and failure to treat maternal infections that could threaten the child.

See also: How Common are Birth Injuries and Birth Defects?

Safe Delivery: Improving the Odds

First, there are some things that doctors and hospitals should be doing to decrease the incidence of preventable birth injuries. They need to implement better practices for identifying at-risk mothers before delivery so that they’re prepared for possible complications. They also need to practice and drill for complicated deliveries so that they can quickly and properly perform any necessary treatment.

Next, there are some things you can do increase the odds of a safe delivery. Most importantly, you’ll need to be proactive in your prenatal care and during delivery. Make sure you’re honest with your doctor about all of your health conditions and risks and ask questions about what that might mean for your pregnancy or delivery. When choosing where to give birth, ask your midwife or health care provider about their initiatives for improving the safety of the childbirth process. Ask them about their experience in dealing with childbirth complications — you don’t want to go through a prolonged or difficult delivery with someone who has never dealt with one before.

And during delivery, be clear and vocal about how you’re feeling. Even a headache or a tingling in your toes could be the sign of a serious complication. You know your body better than anyone — trust your intuition if you think something is wrong. You should also ask questions about any treatments or procedures your health care team wants to perform during your delivery. Make sure you understand the risks and are comfortable with the procedure.

Labor and delivery are scary enough without worrying about preventable birth injuries. Be proactive to decrease the odds of any complications and increase the likelihood of a safe delivery. Should you end up needing to deal with a birth injury, Safe Birth Project may be able to help. Contact us today to get in touch with our team.

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