Bone injuries during birth happen due to the stresses of childbirth and often result in injuries to the clavicle, humerus, skull, or other bones. While many heal without lasting effects, some require immediate treatment to avoid long-term complications. Here are answers to some frequently asked questions about bone fractures during birth.
What Are the Common Types of Bone Fractures During Birth?
The newborn’s bones are still very delicate during childbirth, which can lead to many kinds of broken bone injuries. The most common types of bone fractures during birth are:
- Clavicle (collarbone) fracture: A break in the bone connecting the shoulder to the breastbone, which is the most common bone fracture during birth.
- Humerus (upper arm) fracture: A fracture in the long bone of the upper arm, extending from the shoulder to the elbow.
- Femur (thigh bone) fracture: A break in the thigh bone, the largest and strongest bone in the body, which runs from the hip to the knee.
- Skull fracture: Cracks or breaks in the bones forming the skull.
- Rib fracture: Fractures of one or more rib bones that form the chest cage.
- Radius/ulna (forearm) fracture: Breaks in one or both bones of the forearm, extending from the elbow to the wrist.
- Tibia/fibula (lower leg) fracture: Fractures of the two bones in the lower leg, with the tibia being the larger weight-bearing bone and the fibula the smaller one.
- Pelvic fracture: A break in the bones that make up the pelvic ring, including the sacrum, coccyx, and hip bones.
- Scapular (shoulder blade) fracture: Fractures in the shoulder blade, a flat, triangular bone at the back of the shoulder.
What Causes Bone Fractures in Newborns During Birth?
Bone fractures in newborns during birth are often linked to the natural stress and complications of delivery. However, while many fractures result from unavoidable factors like breech positioning or a baby’s size, some occur due to medical negligence.
These are common causes of bone fractures in newborns during birth:
- Breech positioning: This occurs when a baby is positioned feet- or glutes-first in the womb instead of headfirst. This positioning can make labor and delivery more challenging, often requiring a cesarean section to reduce the risk of complications for both mother and baby.
- Shoulder dystocia: This is when the baby’s shoulder gets caught behind the mother’s pelvic bone during delivery, leading to excessive pressure on the shoulder.
- Macrosomia: Babies larger than average can struggle to fit through the birth canal, increasing the risk of bone injury.
- Improper use of delivery assistance instruments: Forceps or vacuum extractors, when misused, can place undue pressure on a newborn’s delicate bones.
- Prolonged labor: Extended delivery time puts extra stress on the baby, sometimes causing fractures.
- Premature birth: Preterm infants have underdeveloped bones that are more prone to injury.
- Rapid delivery: An extremely fast labor may cause excessive pressure on the baby’s bones.
- Maternal health conditions: Issues like diabetes or obesity can complicate delivery, increasing the risk of birth injuries.
How Often Do Bone Fractures Occur as Birth Injuries?
Bone fractures during delivery are relatively rare, with an incidence of only 1 in 1,000 births. Among common birth injuries, the clavicle is the most frequently fractured bone, accounting for 45.7% of cases. The humerus, femur, and skull are the next three most commonly injured bones at birth.
How Do Bone Fractures During Birth Affect the Newborn’s Development?
Bone fractures during birth can impact a newborn’s development in various ways, depending on the location and severity of the fracture. Most fractures, like those of the clavicle or humerus, typically heal without long-term effects when properly treated. However, more severe injuries may lead to complications like:
- Delayed motor skills: Fractures can temporarily affect the newborn’s ability to move. This restriction during a critical time of development can lead to prolonged delays in motor skill development, such as crawling or reaching.
- Pain and discomfort: The pain associated with fractures can cause the newborn to become irritable, which can impact sleep and feeding patterns.
- Reduced range of motion: A severe fracture may cause the baby to favor one side of the body. This can lead to muscle imbalances that can restrict the baby’s range of motion in the future.
- Long-term deformities: Improper healing can result in growth abnormalities or deformities, especially with skull or pelvic fractures.
What Should Parents Do if They Suspect Their Newborn Has a Bone Fracture?
Parents who suspect their newborn suffered a bone fracture during birth should:
- Seek immediate medical attention: Visit a pediatrician or emergency room to get the baby’s condition assessed as soon as possible.
- Avoid unnecessary movement: Handle the baby gently and avoid putting pressure on the suspected fractured area.
- Document visible symptoms: Take note of any swelling, pain, or limited movement, and share this information with health care professionals.
- Request diagnostic imaging: Ask for an X-ray or ultrasound to confirm the diagnosis and identify the severity and type of fracture.
- Follow the treatment plan: Follow the doctor’s recommendations, which may include splinting, casting, or other treatment methods.
- Monitor for complications: Watch for signs of infection or poor healing, and report them to the pediatrician immediately.
- Seek a specialist’s advice: If needed, consult with a pediatric orthopedic specialist to ensure appropriate care and rehabilitation.
- Seek legal advice: Parents who suspect that the fractures were caused due to negligence should speak with an experienced attorney to explore seeking compensation.
Can Parents File a Lawsuit for a Broken Bone Birth Injury?
Parents can file a lawsuit for a broken bone birth injury if they can establish that negligence caused the injury. To do so, they must prove the following four elements of negligence:
- Duty of care: The health care provider had a legal duty to offer competent care to the mother and baby during delivery.
- Breach of duty: The provider breached this duty by failing to meet the standard of care, such as through improper use of instruments or inadequate monitoring of the baby’s position.
- Causation: The breach of duty directly resulted in the baby’s broken bone injury, showing that the provider’s actions or inaction caused or contributed to the harm.
- Damages: The injury led to specific damages, like medical expenses, pain and suffering, or developmental issues.
Sources
