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Common Birth Injuries: Erb’s Palsy

Michael Becker

Distress during a vaginal birth can increase the risk of many types of birth injury and needs to be handled properly by your doctor to prevent lasting consequences for both mother and child. If during the birthing process your baby becomes stuck in the birth canal, the doctor may utilize assistive methods to pull the child out.

It is during the pulling of the baby’s head and shoulders that an injury may be sustained to the brachial plexus, a birth injury known as “shoulder dystocia.” While most cases are mild and resolve on their own, more severe cases of this birth injury can require surgery to repair. In the most serious of cases, repair is impossible and a permanent birth injury known as Erb’s Palsy develops.

Erb’s Palsy and Cerebral Palsy

Erb’s Palsy is often confused with Cerebral Palsy even though it is actually caused by a completely different type of birth injury. Erb’s Palsy is caused by an actual injury to the brachial plexus and not an injury to the brain or other brain abnormalities as Cerebral Palsy is. Still, Erb’s Palsy causes weakness or paralysis to the arm, similar to some of the potential symptoms of Cerebral Palsy.

Erb’s Palsy is also known by other names depending on how it affects the child’s arm movement. True Erb’s Palsy or Erb’s paralysis is designated when a birth injury causes the paralysis of the upper and lower arm. If the brachial plexus is only partially injured and only the upper arm is affected it is known as a brachial plexus injury.

Another similar name for this birth injury is Klumpke paralysis when the condition affects the hand. In this form, the condition often causes the child’s eyelid opposite the affected hand to droop.

Causes and Diagnosis of Erb’s Palsy

Erb’s Palsy is in most cases preventable through a good pre-delivery assessment of the baby’s position and size, as well as the mother’s condition. Your doctor should assess your birthing plan and look for any preventive measures that should be ready to implement if complications arise.

Some of the risk factors that your doctor should be aware of that may lead to birth injury and Erb’s Palsy include:

  • maternal history of shoulder dystocia complications;
  • a baby in breech position;
  • larger babies (8.5 lbs. or greater);
  • mothers who experienced gestational diabetes or were diabetic before pregnancy;
  • use of labor inducing drugs such as Cervadil, Pitocin or Cytotec;
  • abnormalities in the mother’s pelvic shape or opening; and
  • abnormal position or formation of the child’s head.

Even if the baby is not previously shown to be at risk for birth injury from shoulder dystocia, Erb’s Palsy may occur during labor complications. If the baby becomes stuck while passing through the birth canal, or if the labor is prolonged or otherwise complicated, your doctor may need to intervene. In most cases of Erb’s Palsy, the injury occurs as the doctor pulls the baby’s head and stretches the shoulder and neck, causing a birth injury that may be irreversible.

Once your child is born, your doctor should check for any abnormality in the movement of the arms and hands. If your baby does not show immediate movement in their arms, it may be a sign of a brachial plexus birth injury. During the first days of life, you should be able to see your baby move both arms and hands without difficulty. However, if their arm cannot be lifted even when startled and it falls to the side with the forearm turned inward and wrist bent, this can be a sign of Erb’s Palsy.

Medical Malpractice and Erb’s Palsy

The first step in preventing the risk of a birth injury and development of Erb’s Palsy is for your doctor to be aware of you and your baby’s condition before labor begins. If there are known risks for birth injury, a C-section birth may be suggested to prevent complications.

Even in emergency situations where the risk of shoulder dystocia could not be predicted, your doctor should be well prepared to do whatever is necessary for the safety of you and your baby. Negligence in emergency procedures and reckless action to assist the birth can result in a medical malpractice claim for a resulting birth injury such as Erb’s Palsy.

If you believe your child’s birth injury could have been prevented and it was the result of doctor negligence you may need to file a malpractice claim. An experienced birth injury attorney can assist you with reviewing your case and pursuing legal action.

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