Brain Injury During Birth

Childbirth and pregnancy is an incredibly scary time and a time when all patients put their trust and safety into the medical professionals who are responsible for their care.

It is essential that all tests and checks are carried out during a woman’s pregnancy to identify any potential problems that lead to complications during delivery. Unfortunately, a lack of care during this period can often cause life-changing and catastrophic injuries to both mum and baby. Child brain injuries at birth can impact a child’s life, often resulting in the child needing full-time care, sometimes for the rest of their lives.

Some brain injuries during birth are avoidable, and it is due to a lack of care which causes a significant amount of life-changing harm to babies.

Shrewsbury & Telford Hospital NHS Trust - maternity scandal

An independent review of the maternity services at Shrewsbury and Telford Hospital NHS Trust began in 2017 due to a concern about the treatment provided by this service over a number of years. The review consisted of 1,393 incident examinations which took place between 2009 and 2019. The report found patterns of repeated poor care.

For the review, they graded the maternal and newborn care provided and found that from a review of 147 mothers and 139 babies, 44.2% of mothers and 7.2% of babies were graded at grade 2 or 3 (suboptimal care in which different management might have made a difference to the outcome / suboptimal care in which different management would reasonably be expected to have made a difference to the outcome) for brain damage and cerebral palsy injuries in babies.

There was another review into babies who suffered hypoxic ischemic encephalopathy HIE (a brain injury caused by oxygen deprivation to the brain), which found from 44 mothers and 41 babies that in 65.9% of mothers and 4.9% of babies, the care provided was graded at grade 2 or 3.

The report concluded that there was avoidable harm in at least 304 cases. It was found that there was often a reluctance to refer to specialist services or failures to escalate care and thereafter, a failure to manage complex pregnancies. There was a failure within the maternity services to discuss with colleagues from the wider multidisciplinary team, and throughout various stages, there was a failure to follow national guidelines in relation to the monitoring of the fetal heart rate and maternal blood pressure, which later led to complications.

A brain injury during birth can be caused due to a lack of care and avoidable harm being caused to the mother or baby during birth. For example:

• Failure to monitor mum during pregnancy and correctly assess her risk • Delay in progressing/failure to progress to labour following signs of the baby in distress • Failure to monitor both mum and baby during labour/ failing to identify and react to potential issues such as a drop in the child’s heart rate • Failure to assess the need for surgical intervention during labour • A lack of oxygen or blood going to the baby’s brain (hypoxia) • Physical injuries caused during birth, e.g. excessive use of forceps or vacuum causing a head injury or an injury whilst going through the birth canal. • Infection, e.g. meningitis or maternal infection.

Types of brain damage

Mild – a small amount of brain damage can heal or reverse over time. However, some may continue to affect a child as they develop, causing potential cognitive, physical, and behavioural problems.

Severe – the more severe the brain damage, the more likely the child will suffer from ongoing problems throughout their life. This can lead to a diagnosis of cerebral palsy, epilepsy, or cognitive, developmental and physical delays.

Signs of brain damage in babies

There are key signs in identifying whether a baby has sustained a brain injury; these include an abnormally large forehead or abnormally small head, difficulty eating or swallowing, high-pitched crying, loose muscles, neck stiffness, seizures, sensitivity to light, unusual eye movements or visible scalp injuries.

If one or more of these signs are identified, it is essential that the baby is checked over to prevent any further brain damage.

Hypoxic ischemic encephalopathy is the most common type of brain injury in babies. The longer the period the baby is deprived of oxygen may determine how severe the brain damage/ injury is. In the most severe cases, oxygen deprivation can result in the child sadly passing away or developing a long-term disability such as cerebral palsy.

A brain injury sustained during birth may not be apparent straight away, and symptoms of a brain injury may only appear when the child reaches 2-3 years old. Often an indication of this may be that they are not meeting their developmental milestones.

The effects of the injury on the child and/or symptoms may change as the child grows and their brain develops; the child may experience issues with their mobility or their communication and cognitive function. This may result in the child needing additional help and support with their educational needs, physiotherapy, occupational therapy and, at times, carers to help assist with their daily needs.

How Graystons can help you

Graystons investigate brain injury claims on a day-to-day basis with the hope of helping assist the family in getting the care their child requires and may require in the future.

If you have concerns that you or a family member have experienced substandard medical treatment during pregnancy/labour and a brain injury has been suffered to your child as a direct consequence, we may be able to investigate a potential claim for you; please contact Graystons Solicitors on 0151 645 0055. Alternatively, you can email enquiries@graystons.co.uk, and we can arrange to call you.