Cord Avulsion: Risks, Implications, and the Path to Recovery for Infants

Cord Avulsion: Risks, Implications, and the Path to Recovery for Infants

Umbilical cord avulsion—a rare complication during childbirth—tears the connection between mother and baby, interrupting oxygen and blood flow. When this happens, every decision matters, and the consequences shape your child’s future.

Cord avulsion leaves families with questions: What caused the injury? Could better care have prevented it? The answers lie in both medical facts and legal action.

If you suspect cord avulsion harmed your child, call (888) 894-9067 today to connect with a vetted local attorney in our network who will guide you forward.

What Is Umbilical Cord Avulsion?

Childbirth relies on the body’s ability to adapt to extraordinary demands. The umbilical cord, a flexible and robust structure, connects mother and baby throughout pregnancy and stretches during delivery. 

However, under certain conditions, this adaptability falters. Excessive pulling, abnormalities in the cord, or rapid delivery place strain on the cord, increasing the risk of tearing. When avulsion occurs, the lifeline between mother and baby ruptures, and this moment of joy turns into an urgent medical crisis.

Causes of Umbilical Cord Avulsion

Umbilical cord avulsion doesn’t happen in isolation; specific medical and situational factors often happen in combination. Thankfully, it is quite rare, happening in just 1 in every 1,361 land births (with water births increasing the risk significantly). This risk goes up, however, if the medical team does not respond properly:

Excessive Traction During Delivery

Medical interventions such as forceps or vacuum extractors assist in challenging deliveries. However, improper or forceful use of these tools may exert undue tension on the umbilical cord, leading to avulsion. Misjudging the cord's resilience or failing to recognize its vulnerabilities increases this risk.

Short Umbilical Cords

The average umbilical cord measures between 55 and 60 centimeters. Cords shorter than 35 centimeters are considered short and occur in approximately 6% of pregnancies. A short cord restricts fetal movement and may cause complications during delivery, such as placental abruption, where the placenta detaches from the uterine lining, leading to severe maternal bleeding and potential fetal distress. 

Structural Abnormalities

Certain conditions compromise the umbilical cord's integrity:

• Vasa Previa: Unprotected fetal blood vessels traverse the membranes covering the cervix, making them susceptible to rupture during labor.
• Velamentous Cord Insertion: The umbilical cord attaches to the fetal membranes rather than the placenta, leaving blood vessels unprotected by Wharton's jelly. This abnormal insertion increases the likelihood of vessel rupture during delivery.

Precipitous Labor

Rapid labor progresses swiftly, sometimes completing in less than three hours. This quick progression may not allow the umbilical cord sufficient time to adjust, leading to increased tension and potential tearing.

Risks and Implications for Infants

Oxygen Deprivation

When the umbilical cord tears, it interrupts the flow of oxygen-rich blood from the placenta to the infant. This disruption can lead to hypoxia, a condition where the body lacks sufficient oxygen. Even a brief period of oxygen deprivation can harm vital organs, particularly the brain.

Brain injuries caused by hypoxia often result in conditions like cerebral palsy, which affects muscle coordination and movement. The severity depends on how long the brain was deprived of oxygen and the immediacy of medical intervention. Treatments like hypothermia therapy—where the infant’s body temperature is lowered to reduce brain swelling—are effective but must occur within hours of birth.

Blood Loss: A Hidden Danger

Cord avulsion can cause significant blood loss in newborns, leading to neonatal anemia or, in severe cases, hypovolemic shock. When blood volume drops too low, the body struggles to circulate oxygen and nutrients effectively, compounding the damage.

Neonatal resuscitation and blood transfusions will stabilize infants in these cases, but these interventions carry their own risks.

Neurological and Developmental Impacts

Even with immediate treatment, some infants experience long-term effects. Brain injuries linked to oxygen deprivation or blood loss may lead to:

Motor Skill Delays

Infants may struggle with:

• Sitting: Achieving independent sitting later than typical developmental milestones.
• Crawling: Difficulty coordinating movements necessary for crawling.
• Walking: Delayed onset of walking or abnormal gait patterns.

Speech and Learning Challenges

Brain injuries can result in:

• Communication Impairments: Trouble with speech articulation, language comprehension, or both.
• Cognitive Development Issues: Challenges in areas such as memory, attention, and problem-solving skills.

Seizures

Some children develop seizure disorders due to brain injury sustained at birth, requiring ongoing medical management.

Therapeutic Interventions

Addressing these challenges typically involves:

• Physical Therapy: Enhances motor functions and mobility.
• Occupational Therapy: Assists in developing daily living skills.
• Speech Therapy: Improves communication abilities.

Early intervention will go a long way in maximizing developmental outcomes. However, the financial burden of these therapies can be suffocating for many families. For instance, annual costs may include:

• Occupational Therapy: $5,000 to $10,000
• Behavioral Therapy: Approximately $10,000
• Life Skills Therapy: Around $4,000
• Private Schooling: Up to $20,000
• Private Caregiver: About $9,000

Diagnosis and Detection of Umbilical Cord Avulsion

Umbilical cord avulsion requires prompt detection during labor or delivery to minimize risks to the baby. Accurate and timely diagnosis often determines the difference between manageable outcomes and lifelong challenges.

Prenatal Indicators

While most instances of cord avulsion arise during delivery, some risk factors may be identifiable during pregnancy. Routine prenatal ultrasounds, for instance, can reveal abnormalities such as a short umbilical cord, marginal cord insertion, or conditions like vasa previa. These findings should prompt a detailed birth plan designed to minimize risks during labor.

Medical professionals also monitor for high-risk conditions in the mother, including multiple pregnancies, polyhydramnios (excess amniotic fluid), or a history of complications in prior deliveries. Comprehensive prenatal care lays the groundwork for anticipating potential delivery challenges.

Intrapartum Monitoring

During labor, continuous fetal monitoring is one of the most effective ways to detect cord complications, including avulsion. Sudden, sustained drops in the baby’s heart rate—known as fetal decelerations—can signal an issue with the umbilical cord.

Healthcare providers rely on tools like external and internal fetal heart monitors to track these patterns in real-time. Abnormal readings should trigger immediate evaluation and action, such as repositioning the mother, reducing uterine contractions, or preparing for an emergency cesarean section.

Physical Signs During Delivery

Medical professionals must remain vigilant for physical signs of cord avulsion during delivery. These may include:

• A snapped or visibly ruptured cord: The most direct indicator, often observed after the baby’s head or body emerges.
• Delayed placental delivery: A torn cord can complicate the detachment of the placenta, signaling internal trauma.
• Abnormal bleeding: Either from the infant or mother, which may suggest a rupture in the cord or associated vessels.

Legal Considerations

Umbilical cord avulsion is not always preventable, but there are situations where medical negligence contributes to the severity of the injury.

Medical Malpractice

Medical malpractice occurs when a healthcare provider’s negligence causes harm to a patient. The law defines negligence as a failure to meet the standard of care expected in similar circumstances. This standard is not subjective; it reflects what a competent provider with the same training would do in the same situation.

Key Elements of a Malpractice Claim

To prove medical malpractice, the injured patient must establish four elements:

• Duty of Care: The healthcare provider had a legal obligation to treat the patient appropriately. This duty begins when the patient-provider relationship forms.
• Breach of Duty: The provider’s actions—or lack of actions—fell below the accepted standard of care. 
• Causation: The patient must show that the provider’s negligence directly caused their injury.
• Damages: The injury must result in measurable harm, such as physical pain, financial loss, or emotional suffering.

Examples of Negligence in Cases Involving Cord Avulsion

• Failure to Diagnose Risk Factors: If prenatal tests revealed abnormalities like a short cord or marginal insertion but the medical team ignored these signs, it may qualify as negligence.
• Delayed Response During Delivery: Situations where fetal distress or signs of avulsion went unaddressed may form the basis of a claim.
• Improper Use of Delivery Tools: Excessive force with forceps or vacuum extractors leading to cord rupture strengthens allegations of improper technique.

Legal Framework and Patient Rights

Medical malpractice claims operate within specific legal guidelines that determine how patients seek justice after an injury. These rules govern timelines, evidence, and the types of compensation available.

Statute of Limitations

Every state imposes deadlines for filing medical malpractice claims. These statutes of limitations vary but generally fall between two and three years. For instance:

• New York: Patients have two-and-a-half years from the date of the malpractice or the last treatment related to it.
• California: The limit is three years from the date of injury or one year from the date the patient discovers the injury, whichever comes first.
• Florida: The deadline is two years from when the patient knew or should have known about the malpractice.

Missing these deadlines can bar patients from pursuing legal action, so if you want to take action, the time to act is now.

Burden of Proof

Patients must prove that a healthcare provider’s negligence caused their injury. This involves:

• Demonstrating the standard of care required in the situation.
• Showing how the provider’s actions—or inactions—deviated from this standard.
• Establishing a direct link between the provider’s negligence and the harm suffered.

Expert testimony plays a central role, as medical professionals analyze the evidence and testify about what the provider should have done differently.

Compensation

Victims of medical malpractice may recover damages for:

• Medical Expenses: Costs for corrective treatments, medications, and ongoing care.
• Lost Income: Wages lost due to missed work and diminished earning capacity if the injury affects future employment.
• Pain and Suffering: Compensation for physical and emotional distress resulting from the injury.

Keep in mind that state laws may cap non-economic damages, such as pain and suffering. For example, California limits these damages to $350,000 under its Medical Injury Compensation Reform Act (MICRA).

Steps to Take If You Suspect Malpractice

If a delivery complication like umbilical cord avulsion harmed your child and you suspect medical negligence played a role, taking decisive steps builds your case and protects your family’s rights.

Collect Medical Records

Request all medical records related to your pregnancy, labor, and delivery. Key documents include:

• Prenatal care notes.
• Fetal monitoring strips.
• Labor and delivery charts.
• Documentation of any interventions (e.g., vacuum extraction, forceps use).

Reviewing these records with a medical expert identifies whether deviations from standard practices occurred.

Document Your Experience

Write a detailed account of the events surrounding your delivery, including:

• The timeline of labor and delivery.
• Procedures or tools used during the birth.
• How the medical team responded to complications.
• Any conversations with doctors or nurses about risks or emergencies.

Consult a Birth Injury Attorney

Contact a lawyer who handles birth injury cases immediately. An attorney will explain your legal options, gather evidence, and ensure your case meets all deadlines.

Read our article - Birth Injury Lawsuit: Seeking Justice for Your Family

Obtain Expert Opinions

Your attorney will help engage qualified medical experts to review your case. Expert testimony helps determine:

• Whether the medical team’s actions met the standard of care.
• If any errors caused or contributed to the injury.

Your attorney will incorporate these findings into your claim.

Avoid Direct Communication with the Hospital

Do not discuss your concerns with hospital staff or their representatives without your attorney present. Direct all communication through your lawyer to avoid statements that could weaken your case.

Track Your Child’s Medical Needs

Maintain detailed records of your child’s medical care, including:

• Treatments and therapies received.
• Equipment or medications required.
• Expenses related to care and transportation.

These records help your attorney calculate the damages owed to your family, including ongoing and future costs.

Secure the Future Your Child Deserves

At Cerebral Palsy Lawyer Alliance, our network of birth injury attorneys helps families uncover the truth and pursue justice. A lawyer in your area will investigate medical records, hold negligent providers accountable, and fight to recover compensation for your child’s care and future needs.

If umbilical cord avulsion injured your child, act now. Call (888) 894-9067 to connect with a local attorney ready to fight for your family. Justice begins with your next step.