Background on Shoulder Dystocia and Erb’s Palsy

Most births go well, and the mother and child’s health are not seriously affected by childbirth. However, this is not always the case. A relatively well-known birth injury called Erb’s palsy can occur as the result of shoulder dystocia. Shoulder dystocia is defined as the inability to deliver a baby’s shoulders with gentle downward traction on the head, requiring the physician to engage in additional maneuvering. Generally, this is because the baby is caught behind the mother’s pubic bone. Shoulder dystocia is considered a medical emergency, and immediate action must be taken by the doctor and/or medical team to avoid serious, negative long-term health consequences. 

Shoulder dystocia can cause a variety of birth injuries. The most common is Erb’s palsy, which is an injury of the upper brachial plexus nerves, causing numbness and loss of motion around the shoulder and an inability to flex the elbow, lift an arm or bring objects to the mouth. Palsy is a medical term which means paralysis, often accompanied by loss of feeling, weakness, uncontrolled shaking and other body movements. It’s important to be aware that cerebral palsy, which impairs the brain’s ability to control bodily movements, is different from Erb’s palsy though it, too, can be the result of a shoulder dystocia emergency. 

Erb’s palsy is estimated to occur in approximately 12,000 births annually in the United States, which represents about .9 to 2.6 babies per 1,000 live births. Erb’s palsy affects the brachial plexus, a bundle of five nerves in the neck and torso of the spinal column. These nerves allow the shoulders, arms and hands to move and engage in such activities as playing the piano or throwing a ball. During birth, these nerves can be damaged. In the most serious case, the nerves can be fully stripped away from the spine. More commonly, the nerves are stretched but not torn. 

How Brachial Plexus Injuries Occur

In babies, the brachial plexus nerves in the shoulder are vulnerable during birth. Newborns sometimes develop Erb’s palsy during a difficult vaginal childbirth, or even during a C-section. During delivery, the doctor sometimes must move the baby’s head to one side to make room for delivery of the shoulders. In some cases, that causes the stretching of the nerves, possibly even tearing them, which results in injury to the baby. This type of Erb’s palsy is also called a brachial plexus birth palsy, obstetric brachial plexus palsy or brachial plexus birth injury. 

Large babies may be at an increased risk for brachial plexus injuries. Babies in breech position, where the bottom end comes out first, and those whose labor lasts an unusually long time may also suffer brachial plexus injuries. 

The severity of these injuries can vary widely. Severe complications can include complete or partial paralysis in the affected arm, muscle weakness, and significant loss of motion in the shoulder, arm, hand and/or fingers. Physical therapy is the main treatment option to recover from the symptoms of Erb’s palsy. This treatment focuses on range-of-motion exercises to help babies regain strength and movement in the affected arm.

Some children with brachial plexus birth injuries recover spontaneously, and most children will regain all or most of their normal function through physical and occupational therapy. A smaller group will require surgical intervention to achieve good function. Early diagnosis and treatment can improve long-term results. Fortunately, most babies who develop Erb’s palsy make a complete recovery. However, in severe cases or when left untreated, Erb’s palsy can cause permanent damage. 

Contact An Orlando Birth Injury Lawyer to Learn More About Your Rights

If you are dealing with a devastating birth injury, and you believe that obstetric negligence was involved, it is crucial that you file a medical malpractice lawsuit as soon as possible. The legal process can take time, from identifying expert witnesses to collecting key evidence. In Florida, the medical malpractice statute of limitations is two years from the date of injury or discovery of the injury, and four years from the date of malpractice. However, there are several exceptions to this rule, so it’s important to consult with an Orlando birth injury lawyer as soon as possible.

Note that brachial plexus injuries and Erb’s palsy are not always the result of medical malpractice on the part of your healthcare provider. However, failure to anticipate this situation and use of excessive force likely are often evidence of malpractice. Contact Haliczer Pettis & Schwamm to help you understand if medical malpractice was involved in your child’s birth injury.