Any physical injury that the baby suffers during labor and delivery is called a birth injury. These injuries can vary widely in severity and duration, with some causing temporary discomfort and others leading to long-term disabilities.
Some birth injuries result from the inherent risks of childbirth. However, many birth injuries are preventable. Several maternal risk factors can increase the likelihood of a birth injury, and health care providers must take appropriate precautions to mitigate these risks. By knowing these potential risk factors and taking proactive measures, health care providers can help reduce the occurrence of birth injuries. Here are some of the most common risk factors specific to the mother that carry a higher chance of birth injuries.
Pre-Existing Health Conditions
Pregnant women with pre-existing health conditions are at an increased risk of giving birth to a baby with a birth injury. Examples of high-risk conditions include autoimmune disorders, blood clotting disorders, high blood pressure, obesity, thyroid disorders, and diabetes. These conditions may result in harm to the fetus during pregnancy or make delivery more dangerous.
However, effective treatment options exist for many of these conditions, and proper management can allow a pregnant woman to enjoy a healthy pregnancy and safe delivery. For example, women with blood clotting disorders may require blood thinners during pregnancy in addition to frequent ultrasounds to monitor the baby’s growth and well-being.
Advanced Maternal Age
While many women successfully give birth at older ages, pregnancies considered “advanced maternal age” — usually defined as 35 and older — carry a higher risk of complications. These complications can include premature birth, low birth weight, preeclampsia, stillbirth, genetic disorders, and gestational diabetes.
Advanced maternal age can also result in more difficult labors. This may increase the likelihood of birth injuries by requiring interventions such as forceps- or vacuum-assisted delivery, which sometimes result in injuries to the baby’s head or face. Lack of timely intervention can also lead to prolonged labor and fetal distress.
To reduce an older mother’s risk of delivering a baby with a birth injury, health care providers must perform more frequent prenatal testing screening for these potential complications. If they detect any potential issues, they can take measures to reduce the risk of harm.
Substance Use
Using illicit substances, such as opioids, during pregnancy puts both the mother and unborn child at risk. Substance use during pregnancy can lead to complications such as placental abruption, a dangerous condition where the placenta separates from the uterine wall before delivery. It can also result in preterm labor, low birth weight, and neonatal abstinence syndrome (NAS), which occurs when a baby experiences withdrawal after being exposed to drugs in the womb. Prenatal substance use may also increase the risk of stillbirth.
The risk is not limited to illegal substances. Nicotine, alcohol, and marijuana use during pregnancy can also have harmful effects on the baby’s development and increase the risk of birth injuries. If a pregnant woman is struggling with substance use, health care providers must provide non-judgmental support and resources for early intervention treatment. They must also carefully monitor the mother and baby’s health to identify any potential complications before they become life threatening.
Previous Cesarean Birth
Women who have had a previous cesarean birth may be at risk for complications during subsequent pregnancies. One possible risk is uterine rupture, a potentially life-threatening condition where the uterus tears open along the scar from the previous cesarean birth. Placental position and growth may also suffer damage in subsequent pregnancies after cesarean birth, which can affect the fetus’s oxygen and nutrient supply. The fetus may also have a higher risk of suffering hypoxic-ischemic encephalopathy, a brain injury resulting from oxygen deprivation, if the mother had a prior C-section.
Vaginal birth after cesarean (VBAC) is a common practice, and many women successfully give birth vaginally even after a previous C-section. However, health care providers should only offer this option to women who meet certain conditions. For instance, women who have had one previous cesarean birth with a low-transverse incision have the lowest risk of uterine rupture. Health care providers should collaborate with pregnant women to make an informed decision based on each woman’s individual circumstances and medical history, as each case is unique.
