How Delayed C-Sections Can Lead to Birth Injuries

While most mothers go through labor and birth without any major complications, this is not true for everyone. Sometimes dangerous situations occur in labor and delivery that can cause injury to the baby. When warning signs occur, immediate action is required.

As a nurse, I have seen many situations during labor and delivery that require immediate, skilled actions in order to help keep the mother and baby healthy. There are many dangerous situations that require a C-section (cesarean section or surgical birth) in a timely manner.

When a necessary C-section is delayed, it can cause irreversible harm. While not all injuries can be prevented with a C-section, prolonged infant distress increases the risk for injuries that may have been able to be avoided.

Learn about common reasons why delayed C-sections can lead to birth injuries below.

Fetal Distress

In labor, the baby’s heart rate and heart rate patterns show whether an infant is healthy or not doing well. If these signs of distress are observed and actions by the medical team can relieve the infant’s distress quickly without it remaining, the mother can continue in labor towards a vaginal delivery.

However, if the baby continues to show signs that something may be wrong, a C-section should be done to deliver the baby quickly so the team can make sure the baby is getting enough oxygen.

A prolonged drop in the baby’s heart rate or minimal variability (heart rate fluctuations) are examples that indicate fetal distress. A nuchal cord, when the infant’s umbilical cord is tightly wrapped around the neck, is one example of what can cause drops in the baby’s heart rate. When signs of distress are observed, it is telling the medical team that the baby is not getting enough blood and oxygen.

If these issues are resolved quickly, the baby may not be affected. However, if the baby goes with decreased blood or oxygen for an extended amount of time, this causes injuries.

A birth injury that can result from prolonged fetal distress and a delayed C-section is hypoxic-ischemic encephalopathy (HIE). This condition involves brain damage from lack of blood and oxygen during labor and delivery that can lead to developmental disabilities, learning disorders, and seizures.

Umbilical Cord Prolapse

A cord prolapse is when the baby’s umbilical cord falls down below the baby during labor. The cord falls past the cervix (lower part of the uterus) and enters into the vagina. It often follows the mother’s water breaking (rupturing the amniotic sac that surrounds the baby).

When this occurs, the baby puts pressure onto the cord and causes decreased blood flow to the baby. Lack of appropriate blood flow also means decreased oxygen. This is a medical emergency that requires an urgent C-section.

The nurse who discovers the cord prolapse must internally lift the baby off the cord while the medical team rushes to the operating room. The nurse must continue this action until the baby is delivered in order to prevent a low-oxygen-related birth injury. Delaying a C-section when an umbilical cord prolapse is occurring has a high likelihood of causing severe birth injuries or even infant death.

A birth injury that can result from an umbilical cord prolapse and a delayed C-section is cerebral palsy (CP). It results from damage to the brain and affects muscle control and movement. Children with CP often have seizures and other learning, speech, and swallowing disabilities.

Placental Complications

The placenta is an organ developed during pregnancy that is vital to the health of the baby, providing oxygen and nutrients through the blood. One of the greatest complications that can occur to the placenta is an abruption, or the premature separation of the placenta from the uterus before delivery.

This separation causes blood loss and decreases blood and oxygen to the baby. Failing to monitor the mother or baby closely, or ignoring signs of a placental abruption, can cause distress to the baby and further complications for the mother. An urgent C-section is needed when this emergency is occurring in order to prevent infant injury.

Another complication that requires a timely C-section is a placenta previa. With this condition, the placenta attaches to the lower part of the uterus and covers part of the cervix. As a mother starts going into labor, the cervix starts to soften and widen to prepare for birth. However, with a placenta previa, this can cause the placenta to start losing blood and decrease the blood flow to the baby.

If a mother has this condition, an early C-section should be scheduled to deliver the baby before labor starts. If this condition is undiscovered before labor starts and signs of infant distress or blood loss are observed, the medical team must act quickly to deliver the baby via C-section. Delaying a C-section can result in blood and oxygen loss to the baby, resulting in birth injuries.

A birth injury that can result from complications with the placenta and a delayed C-section is periventricular leukomalacia (PVL). With this condition, there is damage to the white matter in the infant’s brain. Children with PVL have complications with motor function and often experience spastic movements (jerky movements from stiff muscles) and many other health issues, such as vision problems.

Fetal Macrosomia

When a baby is measuring larger than average, particularly over 4,000 grams, they should be diagnosed with fetal macrosomia. Large babies have more risks for injury during birth, and the mother should be educated on the risks involved in having a vaginal birth.

A C-section is often the safest option of delivery for infants with fetal macrosomia to decrease the risk of a traumatic birth and injury. The greatest risk involved in having a vaginal delivery with a large baby is shoulder dystocia. This is an emergency that involves the baby’s shoulders being stuck behind the mother’s pelvic bone during birth after the head has been delivered.

Doctors can use too much force or handle the baby poorly when trying to deliver them, which can cause brachial plexus injuries like Erb’s palsy.

The nerves of the brachial plexus lie along the neck, shoulder, and arm. When these nerves are stretched, torn, or ripped, it can lead to decreased sensation or mobility in the affected arm, with some cases resulting in complete paralysis. Babies also have an increased risk for fractures, especially to the collarbone (clavicle).

If the doctor is unable to deliver the baby vaginally during shoulder dystocia, an emergent C-section is necessary. This situation is traumatic. By the time this is decided, the baby has usually already experienced prolonged hypoxia (lack of oxygen) and is at a very high risk for brain damage.

If the doctors were aware of the fetal macrosomia in pregnancy, a C-section should have been scheduled or performed before the mother was close to delivery. Delayed C-sections, or failing to perform one altogether, can result in severe birth injuries or even infant death if a shoulder dystocia occurs.

Premature and Prolonged Rupture

During pregnancy, the infant is surrounded by an amniotic sac full of amniotic fluid inside the uterus. This protects the baby while they are growing during pregnancy. When this sac ruptures and the fluid is released, often called “water breaking,” the baby no longer has this protection.

If the mother’s water breaks prematurely, the doctor will need to decide (depending on risk factors, including how fragile the baby is and the likelihood of injury in labor) if a C-section is the safest method of delivery for the preterm infant.

Failing to consider the risk factors and delaying a necessary C-section may lead to birth injuries. Preterm babies have a higher risk for developing conditions like an intraventricular hemorrhage (IVH). This is when the blood vessels in the brain rupture and bleed into the brain’s cavities. Preterm babies are more at risk for IVH due to their fragile blood vessels.

Infants with IVH have a higher likelihood of developing long-term brain injuries, like cerebral palsy and other conditions that affect muscle control and movement. Significant developmental delays can follow injuries like IVH.

When a mother’s water breaks, and the baby no longer has this protection, there is a greater risk for an infection. If the amniotic sac has been ruptured for over 18 hours, this is called a prolonged rupture of membranes (PROM).

Once this amount of time has passed, depending on how close the mother is to birth and how many other risk factors are involved, the doctors should be considering if a C-section may be necessary. Delaying a necessary C-section after a prolonged rupture of membranes can lead to the baby getting an infection, with an increased likelihood if the mother is GBS (Group B strep) positive and carries this bacterium.

Infection in a newborn can cause many complications, including breathing issues. A birth injury that can result from an infection acquired during labor or birth is meningitis. This is when the infection affects the meninges, or protective membranes, surrounding the brain and spinal cord.

Meningitis can cause brain damage, seizures, and developmental delays. When the mother’s water has been ruptured for a prolonged period of time, especially if there is a concern for an infection, a C-section should not be delayed.

Understanding Delayed C-Section Negligence Injury Cases

When emergencies occur during labor, timing is everything. A quick delivery after fetal distress is observed, an umbilical cord prolapse occurs, or there is a complication with the placenta can prevent serious birth injuries from occurring.

However, if a C-section is delayed, the consequences can be permanent and detrimental. Conditions like hypoxic-ischemic encephalopathy, cerebral palsy, and periventricular leukomalacia can result from poor decisions made by the medical team.

As a nurse myself, I know how important it is to be on high alert, monitoring the mother and baby closely in labor, and alerting the doctor to any concerning changes. Tragically, this is not true of every medical professional.

Tragically, doctors do not always make the right calls. In many cases, medically necessary C-sections are delayed until it is too late to prevent injury.

Get Help After a Delayed C-Section Birth Injury

I am so deeply sorry if tragedy like this feels all too familiar and you believe that your child, or someone you love, has a birth injury that could have been prevented with a timely C-section.

It is important to know there are people who care deeply about your situation who want to help. Reaching out to a delayed C-section lawyer after a birth injury can help you seek justice for your child and provide support for their medical needs.

Navigating what to do after a birth injury can feel overwhelming and difficult, but you don’t have to do it alone. Our team includes nurses like me who work with delayed C-section negligence injury attorneys across the country to help hold those who provided negligent care accountable.

Call us right now at (800) 914-1562 or fill out this form for a free case review. There’s never any cost to talk with our team.