When the baby is injured at birth

Some babies are injured at birth: a stretched arm nerve, a bruised head, or, rarely, a lack of oxygen called HIE. Most recover. Here is what the words mean.

What it is

A birth injury is harm to the baby during labor or birth. The common ones are mild: a bruise or swelling on the head, a broken collarbone that mends on its own, or a brachial plexus injury, where stretched nerves leave one arm limp for a time. The rare, serious one is HIE, where the brain was short of oxygen.

Each happens in roughly 1 to 3 of every 1,000 births. Most are no one's fault.

What's typical

A collarbone mends in two to three weeks. About 8 or 9 in 10 brachial plexus injuries recover fully within three to six months with gentle exercises. Cooling for HIE starts within six hours of birth and lasts three days. Outcomes after HIE range from full recovery to lasting disability.

What's known

Trials of cooling found lower rates of death and disability after moderate to severe HIE, so it is now standard in NICUs. California's Early Start program offers free early intervention for babies with a nerve or brain injury.

What helps

Ask the NICU or pediatrician to draw it for you: what was injured, what mends, what is watched.
Ask for an Early Start referral before you leave the hospital.
Get a birth debrief for yourself. A hard birth is yours to process too.

When to call someone

Nowthe baby is limp, blue, not feeding, or has a seizure. Call 911.
Todaythe arm is still not moving after a week.
At your next visitask about a specialist referral, Early Start, and a therapist for you.

Who helps

PediatricianPerinatal therapistBodyworkerOB-GYN

Tools: My Birth Team · Birthworker Directory

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Sources

American Academy of Pediatrics (HealthyChildren.org) — Brachial plexus injuries in newborns
Hope for HIE — What is HIE: parent guide
Cochrane Library — Cooling for newborns with hypoxic ischaemic encephalopathy (systematic review)
California Department of Developmental Services — Early Start program

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