Birth asphyxia happens when a baby doesn’t get enough oxygen (oxygen deprivation) before, during, or right after birth. It can result from any number of issues, including an interruption in the flow of blood between a mother and baby, a blood circulation problem, or even an airway blockage after birth. When a baby is deprived of oxygen for a period of time, it can lead to hypoxic-ischemic encephalopathy (HIE), a type of neonatal brain damage.
HIE is associated with a number of disabilities, including cerebral palsy, epilepsy, visual impairment, learning disabilities, and developmental delays. The long-term effects of birth asphyxia are based on the severity of the oxygen deprivation, the length of the oxygen deprivation, and the baby’s condition when they were deprived of oxygen. Immediate treatment using therapeutic hypothermia (cooling therapy) shortly after birth can help to reduce the impact of birth asphyxia and minimize brain damage.
Birth asphyxia, HIE, and other birth injuries are often preventable. Health care providers who fail to properly diagnose or treat birth asphyxia – or conditions that may cause perinatal asphyxia – may be liable for medical negligence.
Causes of Birth Asphyxia
Birth asphyxia – which may also be referred to as perinatal asphyxia – has a number of potential causes. When a fetus is in utero, blood carrying oxygen and nutrients travels from the mother to the baby through the umbilical cord. If some type of obstruction prevents adequate blood flow, it can affect the amount of oxygen that the baby receives and may cause perinatal asphyxia.
This may occur when the mother’s blood pressure drops, when there is a true knot or other obstruction in the umbilical cord like umbilical cord compression, or if there is an issue with the uterus or placenta. When this happens, it is a true medical emergency and the baby must be delivered promptly to reduce the risk of brain damage.
There are certain risk factors associated with birth asphyxia, including:
- Anaesthesia errors
- Low amniotic fluid (oligohydramnios)
- Placental issues, including placental abruption, placenta previa or placental insufficiency
- Umbilical cord problems, including a short umbilical cord, nuchal cord, cord compression, umbilical cord prolapse, vasa previa, or an infection
- Uterine hyperstimulation, which is often brought on by labour-enhancing drugs like Pitocin
- Premature birth
- Prolonged labour
- Premature rupture of membranes
- Postmaturity syndrome
- Failure to deliver when common signs of fetal distress are present
It may be a form of medical negligence if a medical professional fails to intervene when an infant shows signs of fetal distress. If there is any indication that a baby is being or has been deprived of oxygen, then an emergency caesarean section (c-section) may be necessary.
Complications and Long-Term Effects of Birth Asphyxia
If the birth asphyxia is severe enough or lasts long enough to cause a neonatal brain injury, then the baby will often develop hypoxic-ischemic encephalopathy (HIE) after birth. HIE is a type of brain injury that often leads to permanent brain damage and disability.
In the short term, a baby with a hypoxic-ischemic brain injury may suffer from neonatal seizures, hypotonia (loose and floppy body), multiple organ problems, poor brain stem reflexes, poor feeding, and/or a depressed level of consciousness. A baby with HIE may not be alert, have an abnormal response to light, have difficulty breathing, and have challenges with their blood pressure and heart.
Many of these short-term effects can cause long-term complications if not appropriately diagnosed and treated. For example, neonatal seizures caused by hypoxic-ischemic encephalopathy can cause additional brain damage if not treated. Similarly, babies who have difficulty breathing or regulating their blood pressure may suffer further brain damage if they do not receive prompt treatment.
Many babies who are deprived of oxygen at or near birth are diagnosed with hypoxic-ischemic encephalopathy. Some children with HIE will not have any long-term effects. However, babies who have permanent brain damage from HIE may develop a number of conditions, such as:
- Cerebral palsy (CP) and other motor disorders
- Developmental delays
- Hearing impairments
- Visual impairments or blindness
- Epilepsy and other seizure disorders
- Learning disabilities
- Behavioural and emotional disorders
- Orthopaedic issues
- Mental health conditions
- Feeding problems and nutritional concerns
- Respiratory conditions
The long-term outcomes of birth asphyxia depend on how serious the brain injury was and where it occurred. When an infant has HIE, brain scans often show lesions. These lesions – or scars – may be on the basal ganglia, thalamus, brain stem, cerebral cortex, or subcortical white matter. The area where these lesions are located can significantly affect the extent of a child’s disabilities.
For example, if a baby suffers damage to the cerebellum – which is located at the top of the brain stem – it may affect their motor control. Damage to the cerebellum can cause balance issues, tremors, and other problems. By contrast, damage to the cerebrum (another part of the brain) can lead to problems with cognitive function, including memory, perception, and judgment.
Children who have been diagnosed with HIE often require significant levels of medical care and long-term therapy and treatment. This can be a source of tremendous financial and emotional strain on families. If birth asphyxia was caused by medical negligence, a lawsuit may help you recover the compensation that you need to provide for your child after they suffered a birth injury like HIE, neonatal encephalopathy, or cerebral palsy.
Treatment for Birth Asphyxia
If a doctor suspects that a baby has experienced a lack of oxygen during labour and delivery and is at risk of neonatal asphyxia, then an emergency c-section is typically necessary to prevent or minimize brain damage and possibly save the baby’s life. Once a baby has been diagnosed with HIE, the next step is to administer therapeutic hypothermia or whole-body cooling. Generally, hypothermic therapy must be administered within 6 hours of neonatal asphyxia.
The process involves using a cooling cap or blanket to lower a newborn’s body temperature to 33.5 degrees Celsius. This lower body temperature is maintained for a period of 72 hours. Therapeutic cooling slows the baby’s metabolic rate, which gives cells the chance to recover, preventing further brain damage.
A failure to administer cooling therapy in a timely fashion may be another form of medical negligence. Therapeutic hypothermia is considered the best treatment for HIE and is shown to reduce the likelihood of adverse outcomes.
Can Babies Fully Recover from Birth Asphyxia?
Infants who experience mild or moderate perinatal asphyxia may fully recover. However, if they suffered more severe birth asphyxia, they will likely have permanent brain damage that could lead to severe adverse outcomes, including epilepsy, cerebral palsy, and developmental delays.
The key to reducing the risk of brain damage is prompt intervention if an electronic fetal heart monitor (EFM) reveals signs of fetal distress. After birth, a baby with HIE should receive cooling therapy within 6 hours to stop the spread of brain damage.
Can Birth Asphyxia Be Prevented?
Possibly. There are certain risk factors associated with neonatal asphyxia. If a pregnant person or the fetus has any warning signs, they should be closely monitored. Proper prenatal care can reduce the risk of birth asphyxia and other birth injuries.
If a baby does suffer brain damage or HIE due to a lack of oxygen, then systemic hypothermia through therapeutic cooling should be employed to minimize the potential for further brain damage. A failure to promptly assess a baby after birth using the Apgar test and to provide therapeutic hypothermia may be considered medical negligence.
How a Birth Injury Lawyer Can Help
When the blood vessels in an umbilical cord are compressed or obstructed, a baby may suffer oxygen deprivation or birth asphyxia. This can cause brain damage that leads to a range of serious, long-term complications such as cerebral palsy, epilepsy, and even death. Children who suffer these adverse outcomes often require lifelong care, medical intervention, and therapies.
If your child has been diagnosed with a birth injury related to neonatal asphyxia, you may be entitled to compensation for a medical provider’s negligence. The experienced HIE lawyers at BILA can advocate for you and your family’s rights. With a network of lawyers throughout Canada, we offer skilled, compassionate legal representation for families whose lives have been affected by birth asphyxia.