What Is a Birth Injury — and How Do You Know If One Occurred?

Every year, approximately 7 out of every 1,000 babies born in the United States experience some form of birth injury. That number is higher than most people expect — and many of those injuries are preventable.

As a childbirth attorney, I've spent years reviewing birth records, talking to families, and understanding exactly how and why these injuries occur. My goal has always been the same: help parents understand what happened, and help prevent it from happening to someone else.

Here's what every expectant and new parent should know.

What Counts as a Birth Injury?

A birth injury is any harm that occurs to a baby during labor, delivery, or immediately after birth. This is different from a birth defect, which is typically genetic or developmental in origin.

Birth injuries can range from mild and temporary to severe and permanent. Common types include:

• Brachial plexus injuries — damage to the nerves controlling the arm and hand, often caused by excessive force during delivery
• Hypoxic-ischemic encephalopathy (HIE) — brain damage caused by oxygen deprivation during labor
• Cerebral palsy — a group of disorders affecting movement and muscle tone, sometimes linked to birth complications
• Facial nerve injuries — often caused by forceps use
• Cephalohematoma — a collection of blood beneath the scalp, typically from vacuum or forceps delivery
• Fractures — most commonly the clavicle, occurring during difficult deliveries

How Do Birth Injuries Happen?

Birth injuries can result from a number of factors, but they generally fall into two categories: unavoidable complications and preventable errors.

Unavoidable complications include things like an unusually large baby, an unexpected cord prolapse, or a sudden placental abruption. Even with perfect care, some deliveries involve emergencies that cannot be fully anticipated.

Preventable errors are a different matter. These include:

• Failure to recognize or respond to fetal distress on the monitor
• Delayed decision to perform a C-section
• Improper use of forceps or vacuum
• Mismanagement of shoulder dystocia
• Inadequate monitoring during labor
• Medication errors

The distinction matters — not just legally, but for families trying to understand what happened to their child.

Warning Signs to Watch For

Some birth injuries are obvious at delivery. Others don't become apparent until days, weeks, or even months later. Here are signs that warrant immediate follow-up with your pediatrician or a specialist:

In the newborn period:

• Seizures or unusual jerking movements
• Difficulty breathing or feeding
• Limpness or unusual muscle tone
• Asymmetrical movement of the arms
• Bruising or swelling on the head or face

In the weeks and months after birth:

• Missing developmental milestones
• Persistent weakness on one side of the body
• Difficulty with fine motor skills
• Vision or hearing problems
• Unusual muscle stiffness or spasticity

If you notice any of these signs, trust your instincts. You know your baby. Advocate loudly and early.

What Should You Do If You Suspect a Birth Injury?

First, focus on your child's medical care. Get the evaluations and specialist referrals your baby needs. Document everything — keep a journal, save all medical records, and write down what you were told and when.

Second, request a complete copy of your birth records, including the fetal monitor strips. These records are yours by right, and they tell the story of your labor in detail that is often critical to understanding what happened.

Third, consider speaking with an attorney who specializes in birth injuries. Not because you're looking for a fight — but because you deserve to understand whether what happened to your family was preventable.

You Are Not Alone

If your child has been injured at birth, the grief and confusion you feel are completely valid. So is the need for answers.

My book, A Parent's Guide to a Safer Childbirth, was written in part for families in exactly this situation — parents who are trying to understand a complicated medical event while also caring for a child who needs them. I hope it helps.

And if you have questions, I'm here.