The scary truth about childbirth is that it's unpredictable. It may be safer today than ever before in history — in the United States, about 1 in 4,000 women die in the process, compared to 1 in 100 in the 18th century. But nonfatal injuries in childbirth continue to wreak havoc on women's and babies' bodies, and the most serious of them are debilitating for life.
And these birth injuries are more common than you might think: In the United States, we see them in 7 out of 1,000 babies.
Cerebral palsy is the most common and most serious condition caused by birth injury. A term used to describe a group of movement disorders that disrupt a child's nervous system, cerebral palsy is caused by damage to the developing white matter of the brain — the part that sends signals throughout the body to control movement. When damaged, white matter can't send these signals, leading to abnormal development of the brain and body.
In many cases, the exact cause of birth injuries like cerebral palsy can be difficult to determine. But often, it's clear they are a result of preventable medical errors, and that's why cerebral palsy continues to be the subject of many medical malpractice lawsuits. Let's take a look at the different types of cerebral palsy and some of the most common risk factors.
The Main Causes and Risk Factors of Cerebral Palsy
The brain's white matter is more sensitive to injury between 26 and 34 weeks, according to the National Institute of Child Health and Development, but the brain damage that leads to cerebral palsy can happen at any time — during pregnancy, during birth, or shortly after birth.
Risk factors include:
Lack of oxygen to the brain
Oxygen deprivation is one of the more common birth injury causes, usually due to very low blood pressure in the mother; an abnormality or rupture in the uterus, placenta, or umbilical cord; or extreme blood loss after birth. When these problems go untreated and block oxygen to the baby's brain for a long time, the resulting brain damage can lead to developmental delays and permanent behavioral or speech problems.
Maternal infections or medical conditions
When medical professionals fail to spot signs of an infection in the mother — meningitis, chickenpox, or bacterial infections of the placenta, for example — the infection can cause inflammation in the baby that leads to brain damage. Mothers with thyroid problems, intellectual disability, seizures, or fever during pregnancy or delivery are at higher risk of having a child with cerebral palsy.
Children who were born before the 37th week of pregnancy have a greater chance of having cerebral palsy, according to the Centers for Disease Control and Prevention (CDC). In premature babies, small portions of brain tissues can die, leading to major nervous system problems and developmental delays.
Low birth weight
Studies have also shown a greater risk for cerebral palsy in children who weigh less than 5.5 pounds at birth, and especially those who weigh less than 3 pounds. These infants face a number of challenges. Low birth weight means their bodies and nervous systems may not have yet fully developed, putting them at risk of complications like breathing problems and the above material infections that can lead to cerebral palsy.
In the wake of medical advances related to assisted reproductive technology (ART), more women are having multiple children. But when doctors lack the training or experience to manage this emerging technology, twins, triplets, and other multiple births have a higher risk for cerebral palsy — especially if a baby’s twin or triplet dies before birth or shortly after birth. Multiple pregnancies are often born prematurely or with low birth weight, amplifying the risk.
Jaundice and kernicterus
Jaundice is a condition seen in newborns that turns the skin and whites of the eyes yellow, due to a build-up of a chemical called bilirubin in the baby’s blood. When too much bilirubin is allowed to build up and jaundice goes untreated, it can cause a type of brain damage called kernicterus, leading to cerebral palsy and other conditions.
Bleeding in the brain
A fetus can have a stroke when blood vessels in the brain are blocked, broken, or abnormally formed. This happens in babies with a heart defect at birth, blood clotting problems, or sickle cell disease that isn't properly treated. Sadly, it can also result from severe trauma to the infant's head when a medical professional incorrectly uses delivery assistance tools (like forceps or vacuum extractors) during labor or delivery.
Cerebral Palsy and Other Birth Injuries
The risk factors noted above don't always lead to cerebral palsy, but they can lead to other birth injuries, including:
- Erb’s palsy
- Facial nerve damage
- Skull fractures or bone fractures
All birth injuries can range from mild to severe. But the more serious consequences can last a lifetime, both in terms of symptoms and their costs. Caring for a child’s cerebral palsy or other disabilities can cost an estimated $1 Million over the child’s lifetime, according to the (CDC). That's 10 times greater than the cost of care for the average person and financially devastating to many families — not to mention the emotional toll and impact on the family's quality of life.
Learn more about birth injuries, FAQs, and support available for families here.