What Qualifies as a Birth Injury?

What Qualifies as a Birth Injury?

Roughly seven out of every 1,000 babies born in the U.S. suffer a birth injury. But what exactly qualifies as a birth injury? 

In plain terms: any physical harm a newborn suffers before, during, or just after delivery. Some injuries are unavoidable. Others? They shouldn’t have happened. That’s where the law comes in.

If you suspect medical negligence played a role in your child’s injury, it’s time to get answers. At Cerebral Palsy Lawyer Alliance, our network of lawyers works nationwide to connect families like yours with trusted, experienced birth injury attorneys. Call (888) 894-9067—a local lawyer will review your situation and explain your legal options.

Understanding Birth Injuries

Birth injuries aren’t rare medical flukes. They’re physical harm done to a newborn during labor, delivery, or immediately after birth. Some happen because of natural complications. Others? They stem from mistakes—avoidable ones.

The term birth injury refers to physical trauma sustained by an infant as a result of mechanical forces during the birthing process. Think of pressure, pulling, twisting—forces that, when applied incorrectly or excessively, damage delicate newborn bodies. The legal system tends to focus on these injuries when they result from substandard medical care.

A birth injury isn’t the same as a birth defect. That distinction matters. A birth defect usually develops before birth, typically due to genetic factors or prenatal exposure to harmful substances. A birth injury happens at birth or shortly after because something went wrong in the delivery process.

These injuries range in severity. Some heal on their own, leaving no trace. Others lead to permanent disabilities—paralysis, cognitive impairments, or developmental delays. When injuries result from negligence, the law allows families to pursue compensation under medical malpractice statutes, which vary by state. For instance:

• Arizona Revised Statutes § 12-561 defines medical malpractice as negligence by a healthcare professional that causes injury.
• California Civil Code § 3333.2 places a cap on non-economic damages in malpractice cases, including those involving birth injuries.

Common Types of Birth Injuries

Some injuries leave bruises that fade. Others leave scars that shape an entire life. Birth injuries show up in different ways, depending on where and how the trauma occurs during delivery. Here’s a breakdown of the most common types.

Head Trauma

The head bears the brunt of a difficult delivery. Newborn skulls are soft, designed to compress slightly during childbirth. But excessive force—whether from prolonged labor, improper use of forceps, or vacuum extraction—can cause damage.

• Caput Succedaneum: This is swelling of the soft tissues on a baby’s scalp. It usually happens when pressure from the birth canal or suction from a vacuum extractor causes fluid buildup. While it looks alarming—think of a puffed-up lump on the baby’s head—it usually resolves within a few days without lasting effects.
• Cephalohematoma: This involves bleeding between a newborn’s skull bone and its fibrous covering, the periosteum. The culprit is typically pressure during birth or forceps use. Unlike caput succedaneum, the swelling here is more localized and doesn’t cross the suture lines of the skull. It might take weeks or months to disappear. Some cases lead to jaundice, infections, or calcification, requiring medical intervention.

Nerve Damage

When a baby’s body gets twisted or pulled during delivery, nerves can tear or get compressed. This damage disrupts communication between the brain and muscles, leading to paralysis or weakness.

• Brachial Plexus Injury: The brachial plexus is a network of nerves that controls movement and feeling in the shoulders, arms, and hands. Injuries happen when the baby’s shoulder gets stuck behind the mother’s pelvic bone—what doctors call shoulder dystocia—and the provider pulls too hard. The result ranges from temporary weakness to permanent paralysis of the arm. Erb’s Palsy is one form, marked by limited motion and a limp arm. Severe cases involve nerve ruptures or avulsions, where the nerve root is torn from the spinal cord.
• Facial Nerve Palsy: This happens when pressure damages the facial nerve during delivery, often because of forceps use or the baby pressing against the mother’s pelvic bones for too long. You might notice the baby’s face looks uneven when crying—one side moves normally, the other doesn’t. Mild cases heal in weeks, but if the nerve was torn, surgery might be the only fix.

Bone Fractures

Broken bones in newborns typically point to rough handling during delivery, particularly when there’s a mismatch between the baby’s size and the birth canal or when shoulder dystocia occurs.

• Clavicle Fractures: The collarbone is the most commonly broken bone during birth. A fractured clavicle might not be obvious immediately. Sometimes it’s picked up when the baby doesn’t move one arm or cries when touched near the shoulder. While these fractures usually heal quickly with immobilization, improper handling during delivery might bring up questions about medical negligence.

In states like Illinois, 735 ILCS 5/2-622 requires a written report from a healthcare professional stating that medical negligence probably caused the injury before filing a birth injury lawsuit. These types of injuries are often the core of such cases, especially when the birth team failed to follow standard procedures or mismanaged labor.

Risk Factors for Birth Injuries

Some deliveries are smooth. Others hit speed bumps. And sometimes, those bumps are big enough to cause permanent damage. Certain factors crank up the risk of birth injuries. Some of them are tied to the baby, others to the mother, and some to how the labor itself unfolds.

Infant Factors

• Macrosomia: This is the medical term for a baby who weighs more than 8 pounds, 13 ounces at birth. Bigger babies don’t just make for tougher deliveries—they increase the chance of shoulder dystocia, where the baby’s shoulder gets stuck behind the mother’s pelvic bone. That’s when medical teams might pull harder, increasing the risk of nerve damage like brachial plexus injuries. According to ACOG Practice Bulletin No. 173, macrosomia raises the chance of birth trauma significantly, and physicians are expected to manage labor and delivery with that in mind.
• Prematurity: Babies born before 37 weeks aren’t just smaller—they’re more fragile. Their muscles, bones, and nerves haven’t fully developed, making them more vulnerable to fractures, bleeding in the brain, and respiratory distress. The Centers for Disease Control and Prevention (CDC) reports that preterm birth complications are a leading cause of long-term neurological disabilities in children.

Maternal Factors

The mother’s health and physical condition play a major role in how labor progresses—and how much risk there is for injury.

• Cephalopelvic Disproportion (CPD): CPD happens when the baby’s head or body is too large to pass through the mother’s pelvis. Labor stalls. Doctors may try vacuum extraction or forceps delivery to get things moving. Misuse of these tools increases the likelihood of physical injury to the baby, including skull fractures and nerve damage. In these situations, failing to recommend a cesarean section might be seen as negligent. Under Texas Civil Practice and Remedies Code § 74.001, substandard decisions during delivery that lead to injury could qualify as medical malpractice.
• Obesity: Maternal obesity increases the risk of macrosomia, gestational diabetes, and preeclampsia, all of which complicate labor. Obesity also makes cesarean deliveries more likely. If a physician fails to properly monitor or plan for these risks, it may constitute negligence under Florida Statutes § 766.102, which outlines the standards for proving a healthcare provider’s deviation from accepted practice.

Labor and Delivery Factors

How labor unfolds is often where birth injuries happen. Timing, positioning, and technique all factor into outcomes.

• Prolonged Labor: Labor that drags on for more than 20 hours for first-time mothers—or 14 hours for those who’ve given birth before—boosts the chances of fetal distress. Prolonged labor can cause compression of the umbilical cord, reducing oxygen to the baby’s brain. If medical teams fail to intervene appropriately, conditions like hypoxic-ischemic encephalopathy (HIE) can result. According to New York Public Health Law § 2805-d, failing to act promptly in the face of fetal distress is considered a departure from accepted medical practice.
• Abnormal Presentation: Ideally, babies come out headfirst, facing the mother’s back. But breech presentations (feet or buttocks first) and transverse lies (sideways) raise the stakes for injury. In these cases, delivery becomes riskier. If a provider attempts a vaginal delivery instead of a cesarean under these conditions, and injury follows, it may trigger legal liability. California Business and Professions Code § 2395 holds physicians to a standard of care requiring that they make delivery decisions consistent with the baby’s position and health.

These risk factors don’t guarantee an injury, but they increase the odds. And when medical providers fail to anticipate, prepare for, or properly respond to these factors, that’s where things can go very wrong.

Diagnosing Birth Injuries

A newborn’s first hours should be about bonding and recovery. But when something feels wrong—when a baby doesn’t move one arm, when breathing seems labored, or when the cry isn’t strong—it triggers a different response. Diagnosing a birth injury starts there: with suspicion.

Most birth injuries make themselves known quickly. The signs are physical. The tools to confirm them are clinical.

Physical Examination

The first tool in a doctor’s hands is observation. Delivery teams and neonatal specialists look for specific warning signs:

• Limited movement in one limb, which could suggest a brachial plexus injury.
• Weak or uneven facial movements, indicating facial nerve palsy.
• Limpness or stiffness, red flags for cerebral palsy or hypoxic injuries.
• Swelling or bruising on the head, pointing toward cephalohematoma or caput succedaneum.

A thorough physical exam includes reflex testing. Delayed or absent reflexes—such as the Moro reflex (the baby’s startle response)—raise concerns. If the exam shows signs of nerve or brain injury, doctors usually order further tests.

Imaging Studies

Looking under the skin brings clarity. When birth trauma is suspected, doctors turn to imaging to map the damage.

• X-rays: The go-to for bone fractures. Clavicle breaks are the most common, but skull fractures may also appear. In cases of suspected cephalohematoma, x-rays help rule out more serious injuries.
• Ultrasound: Used on the brain, especially in preterm infants. Ultrasound detects intraventricular hemorrhage, a type of brain bleed caused by trauma or oxygen deprivation during delivery.
• MRI (Magnetic Resonance Imaging): This scan gives a detailed view of brain structures. It’s crucial when doctors suspect hypoxic-ischemic encephalopathy (HIE), where lack of oxygen has damaged brain tissue. MRIs reveal areas of the brain that show swelling or lesions, helping guide both treatment and prognosis.

Electrodiagnostic Testing

Some injuries hide beneath the surface longer than others. Nerve damage, for example, may not show up immediately. In those cases, specialists use electromyography (EMG) and nerve conduction studies (NCS) to measure the health of muscles and the speed of nerve signals.

These tests usually happen weeks after birth, when the body’s healing—or lack of it—provides a clearer picture. If the nerve doesn’t recover, it points to more serious damage, like avulsion (where the nerve root has torn away from the spinal cord).

Screenings for Developmental Delays

While initial exams may catch obvious injuries, some signs take time. Pediatricians watch for delayed milestones, like rolling over or sitting up, which might suggest cerebral palsy or other neurological injuries. Early intervention programs, recommended by law under The Individuals with Disabilities Education Act (IDEA), Part C, ensure infants receive developmental evaluations and therapies as soon as delays appear.

When medical providers fail to diagnose birth injuries promptly, it doesn’t just delay treatment—it risks worsening the outcome. In legal terms, delayed diagnosis may also serve as grounds for medical malpractice under Georgia Code § 51-1-27, which holds healthcare providers accountable for failing to use a reasonable degree of skill and care.

Diagnosis sets the stage. Without it, treatment doesn’t start, and the legal case doesn’t either. It’s the turning point where medical facts and legal responsibility start to overlap.

Get Answers. Get Accountability.

Birth injuries leave more than bruises. They raise questions that deserve real answers—and accountability. If a delivery injury changed your child’s future, there’s no reason to stay silent or stuck wondering what went wrong.

At Cerebral Palsy Lawyer Alliance, our network of attorneys works nationwide, connecting families to experienced birth injury lawyers who hold negligent providers accountable. Call (888) 894-9067 today. A local lawyer will review your case and explain your legal options.