Erb’s Palsy Causes

Fact-Checked and Medically Reviewed by:
Katie Lavender, RN Registered Nurse
Quick Answer

Erb’s palsy is caused by damage to the brachial plexus nerves, usually during childbirth. The condition is often due to complications during difficult labor or the improper use of assisted delivery tools. While treatment can be extensive and costly, most babies fully recover with the right care. Understanding the causes of Erb’s palsy can help parents get the proper support.

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What Causes Erb’s Palsy?

Close-up of a child's shoulder being gently examined by a medical professional, checking for signs of Erb's palsy.Erb’s palsy causes include injuries to the brachial plexus nerves during childbirth. This can happen if a baby’s neck is stretched to the side or if there is too much pressure on the shoulders during delivery.

Erb’s palsy is a brachial plexus injury often caused by damage to the head or neck during childbirth.”

— American Academy of Orthopaedic Surgeons (AAOS)

The brachial plexus is a network of nerves near the neck that controls movement and sensation in the shoulder, arm, and hand.

These nerves send signals from the spinal cord to the arm muscles, allowing you to move your arm, wrist, and fingers.

Erb’s palsy may require ongoing treatments. However, with proper care, most babies have a strong chance of recovery.

Understanding Erb’s palsy causes helps families figure out what options they may have for securing the financial support needed for their child’s treatment.

For many families, this involves working with an experienced birth injury attorney who can prove the condition could have been prevented.

The Birth Injury Justice Center works with top birth injury lawyers who can help families in all 50 states. Our legal partners have recovered over $962 million for families affected by preventable birth trauma, including Erb’s palsy.

If you suspect your child’s condition could have been avoided, we may be able to help you seek compensation through an Erb’s palsy lawsuit.

Get a free case review right now to find out if you may qualify.

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A free case review is the first step in pursuing compensation for you and your family.

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How Shoulder Dystocia Can Cause Erb’s Palsy

Shoulder dystocia is one of the top Erb’s palsy causes. It occurs when a baby’s head is delivered, but the shoulders become stuck inside the mother’s pelvis.

This medical emergency can place intense pressure on the brachial plexus nerves, leading to Erb’s palsy.

Many cases of shoulder dystocia do not cause lasting harm. However, if nerves are stretched or torn during delivery, shoulder dystocia complications can result in long-term arm weakness, loss of sensation, or even paralysis.

Doctors can take immediate actions to prevent Erb’s palsy by:
  • Making a small cut to widen the vaginal opening (episiotomy)
  • Pressing above the pubic bone (suprapubic pressure) to help the shoulder pass
  • Rotating the baby’s shoulder gently within the birth canal

Acting quickly when symptoms of shoulder dystocia appear is crucial to prevent nerve damage. Delayed response to a shoulder dystocia birth can lead to serious complications, including Erb’s palsy and other nerve injuries.

“The medical team at delivery must act quickly. Delaying intervention by minutes can cause severe birth trauma.”

— Katie Lavender, RN, Labor & Delivery

Risk factors for shoulder dystocia include maternal diabetes, high birth weight, and prolonged labor, which require careful monitoring throughout delivery.

Other Common Causes of Erb’s Palsy

While shoulder dystocia is a primary cause of Erb’s palsy, there are many other Erb’s palsy causes. Any significant stretching or pressure on a baby’s neck and shoulders during childbirth may damage the brachial plexus nerves.

Factors like rapid delivery or difficult labor can increase the risk, especially when the baby’s position or size complicates the delivery process.

Additional Erb’s palsy causes may include:
  • Delivering in a breech position (when the baby is feet- or buttocks-first)
  • Opting for vaginal delivery of a larger-than-average baby (macrosomia)
  • Repositioning the baby improperly during a difficult or lengthy labor

Understanding these risks can help families and doctors take steps to prevent injuries. While some Erb’s palsy causes may be unpredictable, others are often preventable with proper care.

Preventable Erb’s Palsy Causes

Many Erb’s palsy causes can be avoided through proper medical intervention and delivery techniques. By carefully monitoring the baby’s position, size, and the progress of labor, health care providers can reduce risks.

Recognizing when a baby might need alternative delivery options, like a cesarean section (C-section), is crucial in preventing nerve injuries.

Measures to help prevent Erb’s palsy causes include:
  • Choosing a C-section when a large baby or breech position is identified
  • Monitoring labor progress and making timely decisions to avoid complications
  • Using gentle delivery methods to lessen pressure on a baby’s head and neck

Proactive steps by the delivery team are essential for reducing common Erb’s palsy causes. If the right measures are not taken, it may be considered medical negligence.

In these situations, families may be able to sue for Erb’s palsy. Money from a lawsuit can help cover the costs of treatment and ongoing care.

The best way to find out if your child’s condition was due to medical malpractice is to get a free consultation from a skilled legal professional.

Call the Birth Injury Justice Center at (800) 914-1562 or Click to Live Chat to find out if we can connect you right now.

Medical Malpractice as an Erb’s Palsy Cause

In some instances, Erb’s palsy causes result from medical malpractice. This means that health care providers did not follow proper delivery practices to keep your baby safe.

Negligence or improper use of delivery tools can lead to preventable nerve damage. If a health care provider fails to recognize and manage delivery complications, it can cause lasting harm to the baby.

Examples of medical malpractice include:
  • Delaying interventions when faced with delivery complications
  • Failing to assess labor risks, such as the baby’s position or size
  • Misusing delivery tools, like forceps or vacuum extractors

When medical malpractice causes brachial plexus injuries, an Erb’s palsy lawsuit allows families to seek financial support for their child’s treatment and care.

Long-Term Effects of Erb’s Palsy

The long-term effects of a brachial plexus injury at birth, including weakness, limited range of motion, or even permanent paralysis in the arm and shoulder, can significantly affect a child’s quality of life.

Proper diagnosis is essential to determine the extent of the nerve damage. A pediatric specialist will perform a physical examination and may use X-rays, EMG (electromyography), or nerve conduction studies to confirm the condition and assess any related injuries, like a clavicle fracture.

Depending on the severity of the nerve damage, some children may struggle with daily activities and require ongoing medical care. Early intervention is key to minimizing long-term effects.

Did you know

Up to 80% of babies will recover within the first year of life if treatment begins within four weeks of birth, according to Baptist Health.

Erb’s palsy treatment to minimize the chance of long-term effects can be extensive and costly.

Options to manage Erb’s palsy often include physical therapy, range-of-motion exercises, and occupational therapy to improve strength and function.

In more severe cases, Erb’s palsy surgery, like nerve transfers or tendon transfers, may be required, and additional procedures might be necessary to release contractures or repair nerve damage.

For families facing these ongoing medical needs, pursuing lawsuit compensation through an Erb’s palsy settlement can provide much-needed financial support.

A settlement can cover the cost of therapies, surgeries, and adaptive equipment, helping ensure the best possible care and quality of life for the child.

Get Legal Help for Erb’s Palsy

The Birth Injury Justice Center understands that your child’s health and future are what matter most. Money from an Erb’s palsy settlement can provide the support necessary for ongoing treatment, therapies, and long-term care.

We work closely with a network of skilled birth injury lawyers who can help families in all 50 states.

If you qualify, our experienced legal partners will walk you through every step, fighting for the compensation your family deserves.

Our legal network has secured more than $962 million for families affected by preventable birth injuries, and they may be able to help your family, too.

Contact us right now at (800) 914-1562 or fill out our case review form to find out if we can help you provide a brighter future for your child.

Erb’s Palsy Causes FAQs

What are the causes of Erb’s palsy?

Erb’s palsy causes are usually linked to nerve damage during childbirth, often due to difficult deliveries.

Also known as brachial plexus palsy, the condition involves damage to the nerve roots of the upper arm, leading to weakness or loss of movement in the affected limb, often resulting in the classic “waiter’s tip” position.

Obstetric complications during the second stage of labor are a common Erb’s palsy cause, especially when there is pressure on the baby’s neck or improper use of delivery tools.

Does shoulder dystocia cause Erb’s palsy?

Yes, shoulder dystocia can cause Erb’s palsy. When the baby’s shoulder gets stuck behind the mother’s pelvic bone during delivery, the brachial plexus nerves may be stretched or torn, leading to Erb’s palsy. Prompt and proper medical intervention is key to minimizing this risk.

What are the types of brachial plexus injuries?

Brachial plexus injuries vary in severity and can affect a child’s movement and sensation.

These are 4 types of brachial plexus injuries:

  1. Neuropraxia is the most common type of Erb’s palsy and involves stretching the nerve fibers without tearing them, often allowing for a complete recovery.
  2. Neuroma forms when nerve fibers are damaged, leading to scar tissue that presses on healthy nerves. It can partially limit functioning in the affected arm.
  3. Rupture occurs when the nerve is torn but not detached from the spinal cord, requiring possible nerve grafts for repair.
  4. Avulsion, the most severe type, happens when the nerve is torn from the spinal cord and is generally not repairable.

Knowing the type of brachial plexus injury is key to creating the right treatment plan and giving your child the best chance of recovery.

Is Erb's palsy a birth trauma?

Yes, Erb’s palsy is usually a type of birth trauma. It typically occurs when the brachial plexus nerves in a baby’s shoulder are stretched or damaged during a difficult delivery, often due to shoulder dystocia or improper use of delivery tools.

Delayed treatment or failure to properly manage the situation could lead to serious harm. If your child was diagnosed with a brachial plexus injury, we may be able to help.

Call the Birth Injury Justice Center right now at (800) 914-1562 to talk with one of our on-staff labor and delivery nurses.

How do you prevent Erb's palsy?

In many cases, Erb’s palsy causes can be prevented with proper medical care during childbirth.

When doctors use tools like forceps or vacuum extractors correctly and respond swiftly to complications like shoulder dystocia, the risk of brachial plexus injuries is greatly reduced.

Is there a cure for Erb's palsy?

No, there is no guaranteed cure for Erb’s palsy, but most children recover with treatments like physical therapy and, in some cases, surgery.

Early intervention often leads to better outcomes, and many babies regain strength and movement over time.

Does Erb's palsy affect the brain?

Erb’s palsy does not directly affect the brain. It primarily impacts the nerves in the shoulder and arm. It can lead to muscle weakness, limited movement, or paralysis in the affected arm.

How long after birth can you sue for malpractice?

The time frame to sue for birth injury malpractice depends on the statute of limitations in your state. Typically, it ranges from 1 to 3 years after a baby is born.

In some states, there may be exceptions that extend the time to file a lawsuit on behalf of a child. The best way to find out when you should file your birth injury lawsuit is to consult with an experienced attorney.

Get a free case review right now to see if we can connect you with a top birth injury lawyer near you.

Birth Injury Support Team
Reviewed by:Katie Lavender, RN

Registered Nurse

  • Fact-Checked
  • Editor

Katie Lavender has over 8 years of experience as a Registered Nurse in postpartum mother/baby care. With hands-on experience in Labor and Delivery and a role as a Community Educator for newborn care, Katie is a staunch advocate for patient rights and education. As a Medical Reviewer, she is committed to ensuring accurate and trustworthy patient information.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
  1. American Academy of Orthopaedic Surgeons (AAOS). (2023, August). Erb’s palsy (Brachial plexus birth palsy. Retrieved October 8, 2024, from https://orthoinfo.aaos.org/en/diseases–conditions/erbs-palsy-brachial-plexus-birth-palsy/
  2. Baptist Health. (n.d.). Erb’s palsy. Retrieved October 8, 2024, from https://www.baptisthealth.com/services/neurology-care/conditions/erbs-palsy
  3. Cleveland Clinic. (2022, January 23). Shoulder dystocia. Retrieved October 8, 2024, from https://my.clevelandclinic.org/health/diseases/22311-shoulder-dystocia
  4. Johns Hopkins Medicine. (n.d.). Brachial plexus injury. Retrieved October 8, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/brachial-plexus-injuries