Birth Injuries From Prenatal Care

Most birth injuries are unavoidable and the result of natural developmental abnormalities or congenital defects. However, a significant percentage of birth injuries are actually caused by medical negligence and errors by doctors and other professionals. Most of these malpractice-related birth injuries are the result of medical errors during labor and delivery. But birth injuries are sometimes the direct result of negligent prenatal care during pregnancy.

Prenatal care is basically a form of purely preventative healthcare. Good prenatal care is all about careful monitoring and examination of the health of baby and mother as the pregnancy progresses. Expecting mothers undergo a series of regular prenatal checkup exams throughout their pregnancy. A normal exam schedule for prenatal care plan is:

• Every 4-6 weeks during the 6-7 months
• Bi-weekly from week 31-37
• Every 7 days after week 37 to birth

At each visit, doctors and nurses perform physical examinations and track weight, blood pressure and other health indicators. There are also a host of diagnostic tests and lab work ups to screen for common problems and complications. The whole point of the exams and the testing is to monitor for signs of trouble and timely diagnose conditions and complications that could harm the baby or mother. Timely identification of complications and other health problems during pregnancy is critical. When problems are promptly identified, doctors are almost always able to manage or treat them and avoid harm to the baby. Opting for a preemptive c-section is a very common response.

Prenatal errors resulting in birth injuries almost always come in the form of failure to diagnose certain conditions during pregnancy. Prenatal care is strictly preventative in nature so diagnosis is really the sole focus. Diagnosing problems during pregnancy is critical because it enables doctors to treat or manage the problem and keep mother and baby safe. Failure to diagnose and treat health conditions during pregnancy can directly result in birth injuries. The undiagnosed condition can damage the baby's development during pregnancy or it can result in complications or duress during labor and delivery which caused injury to the baby. Below are some common examples of health conditions and complications during pregnancy that often go undiagnosed and lead to birth injuries:

• Maternal Infections: During pregnancy, women are more vulnerable to various infections because their immune system is weakened. Certain maternal infections can be very dangerous for the baby and cause major brain injuries if they are not properly diagnosed and treated. Infections of the amniotic fluid and/or fetal membranes (chorioamnionitis) can be particularly hazardous to the baby. If chorioamnionitis is not promptly diagnosed and treated during pregnancy, it can potentially wreak havoc on the health of the baby before they are even born. Chorioamnionitis, if left unchecked, can cause pneumonia and a serious infection of the blood known as bacteremia. Untreated maternal infections such as chorioamnionitis can also disrupt the normal circulation of oxygen and nutrients to the baby during pregnancy. This sort of oxygen deprivation damages brain cells and causes permanent disabilities like cerebral palsy.
• Fetal Macrosomia: Fetal macrosomia is the medical term for a very large baby (9 lbs. and over). Macrosomia occurs in about 9% of all pregnancies. When a baby is abnormally large (macrosomic) it means vaginal delivery will be very risky. Overly big babies have difficulty passing through the birth canal and often become stuck and get injured. If fetal macrosomia is timely diagnosed during pregnancy, these risks can easily be avoided with a scheduled c-section delivery. Unfortunately, macrosomia is often hard to diagnose. Doctors obviously cannot remove the baby and weigh it during pregnancy, so they have to rely on other indicators of fetal weight such as fundal height and amniotic fluid level.
• Gestational Diabetes: Gestational diabetes is a particular form of diabetes that frequently affects pregnant women. During pregnancy, a woman's body releases certain hormones that make insulin less effective at regulating blood sugar levels. As a result, many pregnant women become diabetic in the later stages of pregnancy. Screening for gestational diabetes is a routine part of prenatal care. When it is timely diagnosed and managed, gestational diabetes is usually not harmful. However, if gestational diabetes goes undiagnosed and treated it can lead to a series of complications that greatly increase the risk of injury to the baby during childbirth.
• Placental Abruption: The separation of the placenta from its site of implantation before the delivery of the fetus is called placental abruption. Functionally, “abruption” is a premature separation of the fetus and placenta from the circulation provided in the uterus of the mother that can lead to oxygen deprivation.  
• Epidural Injury: A lumbar epidural steroid injection is often essential to the birthing process but can cause backaches, hearing loss, neurologic injury, post-dural puncture headache, epidural hematoma, systemic toxicity of local anesthetics, total spinal anesthesia and infection.
• Uterine Rupture: A rupture or tear of the uterus that can cause injury or death to the fetus and the mother.  
• Fertility Treatments: The modern technology of IVF and other fertility treatments have been a blessing for so many families.  The unanswered question in the medical community is whether these treatments increase the risk of birth injuries.