Types of Injuries Babies Can Have During Birth

Woman giving birth
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A birth injury is a serious matter. Rarely during the birth process is a baby hurt, but when it happens, this is called a birth injury or birth trauma. It occurs in about 6 to 8 out of every 1,000 births. A birth injury can occur because of premature birth, the size of the baby (small or large babies), the position of the mother at birth, complicated labor, the position of the baby, and other reasons. It is also more likely in moms who are having their first baby, who have gestational diabetes, or who have pelvic abnormalities.

Caput Succedaneum

This is severe swelling of the baby's scalp. It happens as the baby descends during labor. It is more common in babies who were born with vacuum extraction, though it can also happen if the baby's head presses against the cervix for long periods of time. There can also be bruising in the area of the caput. Generally, this lasts only a few days and the swelling goes away on its own. Your baby may need to have an ultrasound to look for further problems in some cases.

Cephalohematoma

This is bleeding underneath the periosteum (outer tissue covering the bone) in a baby's head. It may not appear right away after the birth but show up several hours later. Treatment is generally not necessary but it may take a few weeks or even months for the blood to reabsorb. It is estimated to occur in about 1% to 2% of spontaneous births but is more common in operative deliveries (forceps and vacuum extraction).

Bruising

Bruising happens as the baby passes through the birth canal and is more common when a baby is born with the assistance of forceps or vacuum extractions. This also goes away on its own typically in a few days. It is also known as forceps marks when forceps are used.

Lacerations

Sometimes a baby's skin is cut by the scalpel in a cesarean section or from a vacuum extractor. Some lacerations may be deep enough to require sutures (stitches), or they may be glued closed. But the vast majority can be bandaged. Infection is also a concern and the wound may be treated with antibiotic ointment. The location depends on how the cut occurs, which may depend on your baby's position in the uterus.

Subconjunctival Hemorrhage

This is a very common occurrence in babies. It can affect one or both eyes and simply looks like redness in the eye. The amount of red depends on the number of small blood vessels broken. It does not need treatment nor does it affect your baby's eyes long-term. The redness can last upwards of a week.

Fractures

Breaking the clavicle (between the shoulder and the neck, also known as the collarbone), is another problem when there are issues delivering the baby's shoulder. Fractures of the humerus (an arm bone) can also occur with a breech delivery. This typically heals with no treatment, though splinting may reduce pain. During the time when your baby's arm is healing, there is little movement on the side of the fracture.

Brachial Palsy

Damage to the brachial plexus, a group of nerves that aids the hands and arms, can cause babies to lose the ability to move their arm. This may be temporary or permanent.

Your baby may need x-rays, MRI or other radiographic tests to see the extent of the injury. Special exercises may be required, like physical therapy during the recovery. This is more common with shoulder dystocia, when your OB provider has trouble delivering your baby's shoulders.

Facial Nerve Paralysis

If excessive pressure is put on the facial nerves at the time of delivery, paralysis can occur. This injury is more common in forceps births, but can occur without the use of forceps. The paralysis is usually seen when the baby cries. The damage may clear up on its own in a few weeks.

Intracranial Hemorrhage

This is when blood vessels are broken inside your baby's skull. This bleeding can occur in many locations depending on what caused the bleeding. It is much more common in premature infants. Signs can include poor feeding and seizures. If your baby is at high risk for bleeding, screenings will be done to check for intracranial hemorrhage.

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