Newborns often incur injuries during the birth process. Many times injuries occur as the baby passes through the birth canal, the final step before his appearance in the world. Birth canal injuries often occur in large babies, who may not fit well through the birth canal, but they can also occur in average-weight babies whose mothers have small or malformed pelvises. Babies not born headfirst or who malpresent in other ways are also more likely to be injured in the birth canal.
Nerve Palsies
Brachial nerve palsy, a nerve injury, most often affects babies who have shoulder dystocia at the time of delivery. Shoulder dystocia occurs most commonly with large babies or in women who are overweight or who have small pelvises. Nerves leading to the arm may be stretched or damaged in the attempts to dislodge and deliver the baby, resulting in weakness or paralysis of the arm or hand. Several types of injury can occur; brachial plexus injuries usually affect the upper arm, while Erb's palsy affects the upper and lower arm and Klumpke paralysis affects the hand. Brachial nerve palsy often resolves within 24 hours, the Lucile Packard Children's Hospital at Stanford reports, but it can take up to several months to improve and can be permanent in some cases.
Facial nerve palsy often follows forceps delivery. Weakness of the facial nerves leads to asymmetry of the face that becomes apparent when a newborn cries. Facial nerve palsy normally resolves within two to three months, the Merck Manual says. Rarely, nerves to the spinal cord can result in paralysis below the injured nerve, which may be permanent. A damaged nerve leading to the diaphragm in the chest can cause respiratory difficulty that usually resolves within a few weeks, Merck says.
Bruising and Bleeding
Forceps often leave bruises on a baby's cheeks that disappear quickly. Babies delivered by vacuum extraction may have swelling or bruising on the top of the head. Accumulation of blood below the skull, called a cephalohematoma, is absorbed within a few weeks or months, the Lucile Packard Children's Hospital says. More serious bleeding into the brain itself, called subarachnoid or subdural hemorrhage, occurs from traumatic delivery or from lack of oxygen during delivery. Subarachnoid hemorrhage most often creates no long-term effects but may cause neonatal seizures. Subdural hemorrhage may cause seizures or jaundice, Merck says.
Caput succedaneum, a soft swelling on the top of the baby's head that may give him a "conehead" appearance, can occur after prolonged pushing efforts or after vacuum extraction.
Fractures
The most common fracture to result from birth canal trauma is fracture of the clavicle, which rarely has long-term effects. The upper arm or leg bone may also fracture, but this occurs rarely, Merck reports. Skull fractures also occur rarely and normally heal without incident.
Asphyxia
Asphyxia, a lack of oxygen, can occur during a difficult delivery. Babies with asphyxia may be limp and unresponsive at birth. Many asphyxiated babies recover completely; others have long-term effects such as cerebral palsy or mental retardation. Some babies who suffer asphyxia in the birth canal don't survive, Merck says.
