children s health issues
Birth Injuries in Newborns
Introduction
Birth injury is harm that can happen to a baby during the birthing process, usually in the process of passing through the birth canal. Many newborns have swelling or minor bruising as a result of the birthing process. Most injuries resolve without treatment. Infrequently, more serious injuries occur, such as damage to nerves or a broken bone. Birth injuries are most commonly due to the natural forces of labor and delivery. Injuries are more likely to occur during a difficult delivery, which may occur because of fetal size, fetal position, forceps or vacuum-assisted delivery, or other factors. A very large baby is at increased risk of birth injury. Doctors recommend Cesarean Delivery (C-section) when they estimate the baby weighs more than 11 pounds (more than 10 pounds when the mother has diabetes). Injury is also more likely when the fetus is lying in an unusual position in the uterus before birth (see figure). In some deliveries, doctors use Operative Vaginal Delivery (a surgical instrument with rounded edges that fit around the fetus's head) or a vacuum extractor device. When used appropriately, there is a low risk of injury with these delivery methods. Overall, the rate of birth injuries is much lower now than in previous decades because of improved prenatal assessment with Overview of General Problems in Newborns , the limited use of forceps, and because doctors often do a C-section if they foresee an increased risk of birth injury. (See also Overview of General Problems in Newborns .) Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (the fetus faces toward the pregnant person's spine) with the face and body angled to one side and the neck flexed. Abnormal presentations include face, brow, breech, and shoulder. Occiput posterior position (the fetus faces toward the pregnant person's pubic bone) is less common than occiput anterior position. 