Cerebral Palsy

A prolonged or traumatic birth puts the baby at risk for developing cerebral palsy by depriving the baby of oxygen during birth. Through a variety of mechanisms, traumatic or prolonged births increase the risks of oxygen deprivation. These can include incorrect use of forceps or a vacuum extractor leading to injury to the umbilical cord or direct injury to the baby’s brain.

The umbilical cord carries oxygen from the mother to the baby. An umbilical cord prolapse occurs when the umbilical cord is trapped between the baby’s head and the birth canal resulting in an umbilical cord compression, or pinching of the cord, reducing oxygen delivery. A cord prolapse must be treated immediately to avoid prolonged oxygen deprivation leading to asphyxia and permanent brain injury.

Shoulder dystocia occurs when a baby’s shoulder gets “stuck” against the mother’s pelvic bone as the baby passes through the birth canal. In this condition, the baby’s head is delivered but his chest is still compressed so he cannot breathe on his own. For a variety of reasons, including umbilical cord compression, shoulder dystocia may lead to decreased oxygen delivery to the baby. Shoulder dystocia must be quickly recognized and properly managed before permanent brain injury from lack of oxygen occurs.

A breech position is when the baby is positioned bottom or feet first, instead of head first, into the birth canal. A breech presentation makes vaginal birth difficult as the baby does not pass through the birth canal normally. This can result in the baby being “stuck” leading to prolonged delivery and increased risk of asphyxia. The majority of babies in the breech position are delivered via a planned cesarean section. If the baby is delivered vaginally and the delivery is not properly managed, a breech birth can result in injuries such as brachial plexus palsy or the devastating complication of cerebral palsy from lack of oxygen to the baby.

Maternal shock is a decreased blood pressure in the mother. It can occur from blood loss during birth or a severe type of infection known as sepsis. If unrecognized and untreated, the decreased maternal blood pressure can injure the mother and lead to inadequate oxygen delivery to the baby resulting in fetal asphyxia.