We get many calls from parents whose children have been diagnosed with Erb’s palsy or Klumpke’s palsy. Though doctors are willing to tell them the prognosis, few will talk openly about what happened during labor and delivery to cause the injury.
These are common injuries—some estimates place it at about 8 in every 1,000 births, which translates to around 31,622 children per year. Sadly, most of these injuries are preventable. First, a few definitions:
- Shoulder dystocia: this is what happens when the baby’s shoulder is caught behind the mother’s pubic bone during labor. When this happens, the baby is trapped, and cannot be delivered without additional help.
- Brachial plexus: a series of nerves from the neck area of the spinal cord which go through the shoulders, down the arms and to the fingers. The brachial plexus is susceptible to injury in the event of shoulder dystocia.
- Erb’s palsy: the most common type of brachial plexus injury, the muscles of the upper arm are completely or partially paralyzed. People with Erb’s palsy cannot move their injured arm completely over their heads.
- Klumpke’s palsy: less common, Klumpke’s palsy features complete or partial paralysis of the hand and forearm. Symptoms will likely include difficulty with fine motor skills
What Causes Brachial Plexus Injuries?
The reason for the injury is fairly simple. When the baby’s shoulder is trapped, the baby is trapped in the birth canal. At this point, the baby must be delivered quickly because he or she is likely not getting enough oxygen. Remember, the mother is still experiencing contractions which push on the baby’s head, the umbilical cord may have pressure on it, and there is limited time to act. If the doctor does not act appropriately, the baby is sometimes pulled and the brachial plexus nerves can be torn or damaged.
Did My Doctor Act Appropriately to Prevent a Brachial Plexus Injury?
Shoulder dystocia has been studied for hundreds of years, and through research, trial and error, and investigation, doctors now know the correct methods to properly and safely dislodge the baby’s shoulder. These tried and true methods are taught in medical school and at continuing medical education seminars. It is extremely likely that every obstetrician will need to use them.
Some of the things doctors will do involve changing the mother’s position, pushing on her stomach in a very specific way, or even placing his/her hand next to the baby’s shoulder in an effort to rotate it out of the way. In extreme circumstances, doctors may perform an episiotomy (cutting a line between the vagina and anus), or pushing the baby back into the birth canal before performing a cesarean.
It may be difficult, but it is important to remember what your doctor did during the labor and delivery if your child is born with any type of brachial plexus injury. This may be difficult, because these injuries may not become obvious until a few days after birth. If you have questions about brachial plexus injuries, contact our medical malpractice attorneys at (855) 712-7818 or online for a free consultation.
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