Breech Baby Delivery Complications
When a woman’s pregnancy nears term, her visits with her doctor typically increase. Both the physician and patient prepare for the upcoming birth, continuously checking on the health of the baby and the mother. In one of those checkups, a doctor may discover that the baby is in a breech position. A breech presentation often complicates the birth process and doctors have several options for managing this situation in a safe manner. All options require careful delivery preparation. Doctors must make critical decisions throughout the pregnancy, but even more so when they discover a baby in a breech position. When complications are possible, they cannot take chances. Doing so may have permanent repercussions for the child harmed or their mother.
If you or your baby have been injured due to incorrect decision-making, insufficient planning and preparation, improper procedures, or other mismanagement of a breech birth, our accomplished birth injury attorneys can help. We have a lengthy track record of success helping moms and babies with birth complications in taking action against negligent medical professionals. Our lawyers can assist you to investigate, assemble, and bring a claim against those responsible for breech-related birth injuries. For a free case evaluation and to speak with an attorney directly, contact us by filling out a request online or calling (866)-708-8617 for immediate assistance.
3 Main Types of Breech Positions
There are three main types of breech positions. The most common one occurs when the baby folds at the hips with legs close to the head and the bottom closest to the birth canal; this is a frank breech presentation. Most breech presentations are frank, but a baby may also be in the complete or incomplete breech position as well. A complete breech on a sonogram shows the baby’s bent knees, and their feet and bottom are closest to the birth canal. In an incomplete breech position, a foot or feet are below the baby’s bottom. Less common in late-term pregnancy, a baby may lie across the uterus side to side in a transverse lie. Instead of the typical vertical position, they lie horizontally, face up or face down, or with one shoulder positioned toward the birth canal.
Possible Reasons for a Baby in the Breech Position
A baby may be in a breech position because the uterus is malformed or due to placenta previa, when the placenta partially or entirely covers the cervix. If the uterus is not in the shape of a pear or has fibroids, that could cause a breech presentation. Other reasons may be the amount of amniotic fluid. When the baby floats in too little or too much amniotic fluid, they may turn to a breech position. Twins and multiple births, prematurity (born less than 37 weeks), and congenital disabilities can also cause a breech baby. However, not every baby’s breech position during fetal development or in the time preceding labor and delivery will have a determined cause.
Risks of Breech Births
Delivering a breech baby vaginally has the potential to seriously endanger the baby. Without turning to a headfirst position at 36 weeks, the baby is unlikely to be born vaginally. However, when the baby is breech earlier in the pregnancy, chances are that they will right themselves into the vertex position or cephalic presentation. Approximately 3 to 4% of near-term babies are breech. Ideally, the baby at 36 weeks is headfirst, faces toward the spine, and stays that way. When the presentation is headfirst but facing upward or toward the belly, the baby may ultimately become stuck at the pubic bone. The position of the head and body makes it harder for the head to move past the pubic bone.
Although it is possible to deliver a breech baby, the risks include dislocated hips, arms, and legs. The baby’s bones may break, or the umbilical cord can tangle, twist or flatten, and cut off the baby’s oxygen supply. Oxygen deprivation often results in severe brain damage or nerve damage. Regardless of the cause, the delivery options are limited to an attempt at manually turning the baby to a headfirst position, a c-section, or vaginal breech birth. Moreover, a vaginal breech birth is not an option with placenta previa, multiple births, low amniotic fluid levels, fetal distress, early water breaking, and vaginal bleeding.
Purpose of an External Cephalic Version (ECV) Procedure
Before labor starts, at 36 weeks, a doctor can determine if the baby is in a breech position and whether a cesarean delivery or an alternative procedure is necessary. A doctor may be able to manually rotate a breech baby during the pushing phase of labor. However, the breech position is detectable before that by physical examination and fetal ultrasound. Before resorting to surgery, an obstetrician may manually attempt to turn the baby in the uterus. The physician can see the specific breech presentation from a physical examination with their hands and an ultrasound before determining whether to attempt an external cephalic version (ECV). The purpose of this procedure is to turn the baby before labor starts.
During an ECV, they apply firm pressure on the abdomen. Applying pressure on specific abdominal areas may force the baby to turn downward. However, it does not always work and may lead to the onset of labor. The success rate is approximately 60 – 65%, with some more recent estimates higher than others. And yet, the risks, though small, may not be worth it to cautious doctors and patients depending on the unique factors of the particular woman, fetus, pregnancy, and childbirth. Beside premature labor, ECV may cause premature rupture of the membranes (waters breaking), premature labor, blood loss for mother and baby, and an emergency c-section. After the procedure, the doctor may decide that a c-section is best for the baby’s safety. The baby’s response to the process and the positioning of the placenta are safety factors to consider.
Cesarean Birth Option when a Baby is Breech
When a pregnant woman’s doctor knows that her baby is in the womb with feet or bottom facing the birth canal rather than the head, they may need to prepare for a cesarean section. A pregnant woman may desperately want a vaginal delivery, but their obstetrician must clearly state the risks to the baby. If the mother wants the physician to attempt an ECV, the risks to the baby and mother should also be clear. It is incredibly dangerous for a physician to perform a vaginal birth or ECV when there is evidence that doing so would risk permanent injury and death to either the woman delivering or her child.
Top Injuries for Infants Delivered in the Breech Position
When a doctor discovers a baby in the breech position, they must be prepared to make timely decisions about cesarean section delivery and carefully study the risks of attempting to turn the baby. Breech babies born vaginally or due to mismanagement of the condition may suffer brain damage and cerebral palsy. These irreversible conditions require lifelong medical attention for seizures, cognitive deficiencies, and muscle spasms, among other disabilities. A mishandled breech birth may also cause brachial plexus injury when the baby’s neck and shoulder are jammed coming out of the birth canal, and nerves become stretched and damaged. It may lead to Erb’s palsy, a temporary or permanent weakness or paralysis in the shoulder and arms. Moreover, spinal damage may cause upper or lower body paralysis. Moreover, decreased blood flow and oxygen can cause hypoxic ischemic encephalopathy (HIE), a type of brain damage leading to muscle weakness or paralysis and cognitive delays.
Connect with a Lawyer if Your Baby Suffered Injuries in Breech Birth
If your baby’s injury is due to medical malpractice with breech birth, contact our legal team at (866)-708-8617 for knowledgeable assistance. It is important to find out what an experienced birth injury attorney says about your claim for damages, as you may have cause for legal action to obtain compensation and seek accountability from those responsible. We have vast learning and practical skill in this unique area of the law, as we concentrate on birth injury and child medical malpractice claims for clients in New Jersey and nationwide. With pregnancy, delivery, and errors frequently occurring when negligent medical professionals take unnecessary risks resulting in injuries, the needs of families and those who suffer the consequences cannot be overstated. For a dedicated attorney’s help regarding your baby’s breech birth injury case, contact us today.