The delivery of a child is one of the most medically complex acts a doctor learns how to perform. Every second can matter, and every movement must be critically assessed. When deliveries need to be sped up, that action has traditionally been performed with forceps, though as medicine evolves, vacuum extractions have become more common. Nonetheless, both methods can lead to problems. It is important to know your rights if things take a turn for the worse.
If a delivery progresses normally, in theory there will be no need for forceps or a vacuum extractor. However, there are reasons why a natural delivery would need to be sped up – namely, if the child is in respiratory distress, or if it is stuck in the birth canal. If this is the case, these tools are used to help the child free itself, though whether a doctor uses forceps or a vacuum extractor may simply boil down to personal preference.
Forceps are a tool used to help guide a baby’s head out of the birth canal. It is designed to fit around a baby’s head, though it is absolutely imperative that the doctor know how much force to use. Too much can cause facial nerve paralysis, and implies a breach of the standard of care. Babies delivered with forceps are also much more prone to spinal cord injuries, specifically in the high cervical vertebrae, which are directly below the skull.
Vacuum extractors, by comparison, are touted as a safer tool due to the lack of human force they require. However, the machine exerts quite a bit of force all on its own. In a study of 134 births delivered with a vacuum extractor, 28 infants sustained some degree of scalp trauma, from superficial to serious. There are clearly positives and negatives about both tools.
Different injuries are more likely with one tool than with the other, but some are depressingly common with both. Brain injuries resulting in neurological trauma happen in 1 of every 664 infants delivered with forceps, and 1 in 860 delivered with a vacuum extractor. Given the relative softness and elasticity of a newborn’s neck, skull and spinal cord, one can reasonably expect that pressure on that area would lead to problems. Developmental delays may occur with brain trauma, which impair motor skills and can sometimes impair cognitive abilities.
Another very common injury with both methods of delivery hastening is an injury to the brachial plexus (BPI), or the network of nerves around the spinal cord that can restrict movement or other bodily functions. The brachial plexus nerves affect the arms, most commonly the upper arms, above the elbow. There are four types of BPIs: (1) avulsion, which is a complete tear of the nerve from its setting; (2) rupture, which is a tear of the nerve root; (3) neuroma, which is when the nerve becomes surrounded by scar tissue and thus inhibited, and (4) praxis, which means a stretching or tearing of the nerve, but not a complete tear.
The most commonly seen BPIs are Erb’s palsy and Klumpke’s palsy, both of which can affect the arms and hands in myriad ways. It depends which of the injuries to the nerve has actually occurred in each case. For example, a baby who has suffered a praxis may recover the use of the arm muscles within days, weeks or months, while avulsion may render the arm largely unusable, simply because no sensation will reach affected areas.
Has Your Child Been Injured?
Even a temporary injury can have an effect on a child’s quality of life, and it is important to know your rights in order to be compensated fairly if the injury is worse. The birth injury attorneys at Meinhart, Smith & Manning, PLLC know the ins and outs of these cases, and we will put our extensive experience to work for you. Contact our Louisville office today for a free consultation.