Birth Injury Prevention

We know that the majority of Erb’s Palsy cases can be prevented.  Therefore, it’s important to educate ourselves about risk factors and to know what to do if these risk factors apply to your pregnancy.  There is no reason to be nervous if you keep these things in mind.

Risk Factors

• Birth weight of infant is over 8.5 lbs.
• Mother has diabetes
• Breech delivery
• Previous child delivered with shoulder dystocia¹
• Small mother
• Long labor
• Precipitous labor (i.e. labor that is faster than normal)
• Fetal malposition in birth canal
• Labor is induced or sped up by medicine
• Use of forceps or vacuum extraction tools during delivery*** (This is super important.  These tools can be very harmful to a baby.)

Prevention

• Doctor should never pull on or twist the baby’s head.
• Have a cesarean section for babies who are too large to fit through the birth canal.  In rare cases BPI can happen during C-sections but it is much less likely.
• Do not deliver the baby on your back. This is the worst position to be in.  Learn about different, more beneficial positions.
• Have a calm birthing environment, so the delivery is not rushed. Your obstetrician or midwife should seem like they can handle a stressful situation like this with ease.

shoulder dystocia¹: when a shoulder gets stuck in the birth canal

For more information about Erb’s Palsy causes and preventions, please watch the video below.  It includes interviews with highly educated professionals in the field who give great insight on this topic.

Do you know of any other risk factors or ways to prevent Erb’s Palsy at birth? I'd love to hear other people’s insights! Please comment below.

Sources:

http://www.brainandspinalcord.org/cerebral-palsy/types/erbs-palsy.html

http://www.birthinjuryguide.org/erbs-palsy/

http://www.erbpalsy.org/prevention.html

What is BPI?

Brachial Plexus Injury (BPI) is a nerve injury, normally caused at birth by constrictions during natural delivery called shoulder dystocia. The brachial plexus is simply a group of nerves that work together to move your shoulder, arm and hand, and can affect your neck as well. This may occur when the infant’s arm or neck is pulled out forcefully in an attempt to get him or her out as quickly as possible.   Usually, the nerves are separated from the spinal cord (avulsion) or overstretched (neuropraxia). 

In my case, this was exactly what happened.  Forceps were illegally used twice in order to pull me out; at the time, in 1989, they could only legally be used once.  In turn, the nerves C5-8 and T1 were overstretched and the only part of my upper left extremity that I could move was my thumb.  I was quickly diagnosed with Erb’s Palsy¹ and Klumpke’s Palsy², which can be generally referred to as BPI, due to neuropraxia. 

Thankfully, my parents were very proactive and, at nine days old, I began physical therapy.  It was important that my arm was moved many times throughout the day in order to “reteach” the nerves.  Within the first two years of a baby’s life, it’s possible that the nerves can fully recover.  However, for most of us, this is a life-long process of improving and maintaining function.

*This injury can be caused by other situations as well.  Car accidents can be one cause, for example.

To learn more in-depth, scientific information about BPI, please see these links:

• Orthobullets
• Hopkins Medicine

¹Erb’s Palsy: upper part of the brachial plexus has been affected (nerves C5-C6)

²Klumpke’s Palsy: lower part of the brachial plexus has been affected (nerves C8-T1)