Lack of Oxygen at Birth

Giving birth – particularly in Canada – is generally regarded as safe. However, birth injuries can and do happen. One of the most common birth injuries involves a lack of oxygen during labour and delivery, which is commonly referred to as birth asphyxia.

A baby who is deprived of oxygen during birth may have a range of complications, including hypoxic-ischemic encephalopathy (HIE). When a baby’s brain does not get enough oxygen, it may cause injury including brain damage, cerebral palsy, seizures, neurological disabilities, and even death.

If your baby was deprived of oxygen during labour and delivery, you may be able to file a claim for compensation based on medical negligence. At the Birth Injury Lawyers Alliance (BILA), we are dedicated to helping families through this difficult time and to getting them the money that they deserve for their losses. Reach out today to schedule a free consultation with a birth injury lawyer in your province.

What Happens When a Baby Has a Lack of Oxygen at Birth?

Two kinds of oxygen deprivation may occur at birth: hypoxia and anoxia. Both types can cause brain damage and related complications. The difference between the two is as follows:

• Hypoxia occurs when oxygen levels are restricted or limited, but the baby receives some oxygen.
• Anoxia occurs when oxygen to a baby’s brain is completely stopped for any length of time.

When oxygen is restricted in any way, the cells of the brain may suffer damage. Unless oxygen is restored to the brain, these cells may die. In more severe cases, oxygen deprivation can cause death.

Several things may cause oxygen deprivation at birth. While some of these situations are unavoidable, others may be caused by medical negligence. This may include a failure to appropriately monitor an infant during the birthing process or a failure to intervene quickly when an infant shows signs of distress.

Common causes of birth asphyxia include:

• Umbilical cord prolapse
• Preeclampsia and eclampsia
• Umbilical cord compression
• Nuchal cord (where the umbilical cord is wrapped around the baby’s neck)
• Issues with the placenta, such as placental abruption or ruptured placenta
• Excessive medication given to the mother
• Maternal recreational drug use
• Trauma to the baby in utero
• A prolonged or difficult labor
• Shoulder dystocia

In addition, jaundice – a common condition that occurs when bilirubin builds up in the bloodstream – may cause oxygen deprivation. If jaundice is not properly treated, it can cause a condition called kernicterus. This can lead to brain damage due to lack of oxygen.

When a brain is deprived of adequate oxygen, it can affect every part of the body – including the lungs, heart, muscles, and brain. The labour and delivery team will assess a newborn for signs of problems with the birth and assign them a rating that is known as the Apgar score. This test is administered 1 minute after birth and 5 minutes after birth.

The Apgar test will examine several key areas of the baby’s well-being, including their:

• Breathing effort
• Heart rate
• Muscle tone
• Reflexes
• Skin color

Each category gets a score of 0, 1, or 2. A lower score indicates that the baby is in distress and may need medical intervention. Any score that is lower than 7 indicates that the baby needs oxygen, physical stimulation to get the heart beating at a healthy rate, or other assistance.

The Apgar score is just one part of the monitoring that should be done for signs of problems. Doctors should also evaluate infants for symptoms of oxygen deprivation, including:

• Poor muscle tone
• Seizures
• Weak reflexes
• Minimal response to stimulation
• Inability to breathe independently 
• Lethargy
• Signs of circulatory problems, such as a weak heartbeat
• Excess acid in the bloodstream (acidosis)

These signs and symptoms will be more obvious with a more severe case of birth asphyxia. If a baby shows signs that they might have been deprived of oxygen, then doctors should act immediately to assess the potential damage and apply the appropriate interventions.

Treatment for Lack of Oxygen at Birth

The impact of oxygen deprivation on a baby will vary based on the individual and the length of time that they lacked oxygen. The type of oxygen deprivation – anoxia vs. hypoxia – will also affect the level of damage. With complete oxygen deprivation (anoxia), brain damage will occur within 10 minutes and death may happen after 25 minutes. With restricted oxygen (hypoxia), it will typically take longer for brain damage and/or death to occur.

These relatively short periods underscore the importance of recognizing the causes and symptoms of oxygen deprivation during birth. With proper monitoring and quick intervention, it may be possible to restore oxygen to the baby – and prevent some of the more serious effects of oxygen deprivation.

One of the challenging aspects of birth asphyxia is that after oxygen is restored, additional brain damage can occur in response to the original injury. Swelling in the brain can then lead to the death of more brain cells.

The best way to treat an injury caused by a hypoxic-ischemic event is with therapeutic hypothermia or cooling therapy. The goal of hypothermia therapy is to reduce the baby’s body temperature to 32.8 degrees Celsius. This is typically achieved using a cooling cap for the head or whole body cooling. Once the baby’s body reaches this temperature, it is maintained for 72 hours.

Reducing an infant’s body temperature slows the metabolic rate. This gives brain cells time to recover, which can prevent brain damage from spreading and becoming more severe. It can also reduce the risk of reperfusion injury, which occurs when the blood flow to the brain is restored too quickly.

Therapeutic cooling is the only immediate treatment for brain injury caused by birth asphyxia. It has a high rate of success in reducing the brain damage caused by oxygen deprivation at birth. If a medical team fails to administer therapeutic hypothermia shortly after birth, it could be a form of medical negligence.

Long-Term Prognosis for Babies Who Are Deprived of Oxygen at Birth

The long-term effects of oxygen deprivation can be serious if a baby is starved of oxygen for a long period. Babies with milder birth asphyxia may recover completely and not have any lasting complications. 

However, if a baby is deprived of oxygen for a longer period, they could experience serious complications – particularly if they experience a hypoxic-ischemic event. Common disabilities associated with this type of brain damage include:

• Cerebral palsy
• Autism
• Developmental delays
• Seizures
• Attention deficit hyperactivity disorder (ADHD)
• Neurological issues
• Intellectual impairments or learning disabilities
• Vision and/or hearing loss
• Sensory processing disorder

There are treatments for many of these disabilities, such as medication, physical therapy, and occupational therapy for cerebral palsy. While these conditions cannot be cured, it may be possible to help your child live a fuller life through early intervention and treatment.

Is Oxygen Deprivation at Birth Preventable?

Not every incident of oxygen deprivation during labour and delivery can be prevented. The key for healthcare providers is recognizing the risk and taking steps to prevent and/or immediately treat birth asphyxia.

The best way to prevent birth injuries related to lack of oxygen is to closely monitor a mother and fetus both during pregnancy as well as during birth. Any signs of a problem should be addressed immediately. For example, if fetal heart monitoring shows that the baby is in distress, doctors may need to perform an emergency cesarean section (c-section) to prevent birth injuries.

There are certain risk factors associated with birth asphyxia. They include:

• Maternal age (under age 16 or over age 35)
• Gestational age of the baby below 37 weeks or greater than 41 weeks
• A history of birth asphyxia during previous pregnancy
• Multiple pregnancies (twins, triplets, etc)
• Gestational diabetes
• Maternal use of drugs and/or alcohol
• Bleeding in the second or third trimester
• Prolonged labor
• The use of a vacuum or forceps to assist in the delivery
• An abnormal position, such as breech, during delivery
• The mother has preeclampsia or eclampsia
• The mother fails to attend prenatal appointments
• Maternal infections
• Premature rupture of membranes

If one or more of these risk factors are present, then the labour and delivery team should be aware and monitor the mother and child appropriately. If necessary, doctors should act quickly to intervene and reduce the likelihood of a birth injury related to oxygen deprivation.

Oxygen deprivation at birth is sometimes caused by medical malpractice. Filing a birth injury lawsuit may be a way to recover financial compensation for your family’s losses. An experienced birth injury lawyer can review your case and advise you of your rights and options for pursuing a claim for medical negligence.

Contact BILA Today to Learn More

Oxygen is vital to human life. If a baby is deprived of oxygen for any length of time, it could lead to brain damage – and in extreme cases – death. While not every case of birth asphyxia is linked to medical negligence, if a doctor fails to appropriately monitor, intervene, and/or treat a mother or baby, it may be grounds for a lawsuit.

The Birth Injury Lawyers Alliance is dedicated to helping families affected by birth injuries get the compensation that they deserve for their child’s injury. If you believe that your baby may have suffered a preventable birth injury, a birth injury lawyer will listen to your story and offer you advice on your legal rights and the potential for filing a claim. For help with a birth injury claim related to lack of oxygen during birth, call BILA today at 1-800-300-BILA or fill out our online contact form to schedule a free initial consultation with a lawyer in your province.