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Welcoming
a new child
into the world should be a joyous occasion
for new parents.
However, when the child is born with a birth
injury, joy is immediately replaced with concern.
Inevitably, questions arise. Why did this
happen? What does the future hold for my baby?
Predictable and Preventable
Erb’s Palsy is a birth injury which is usually
preventable. It occurs when the nerves from
the cervical spine which go to the arm are
stretched or torn during the delivery process.
Unfortunately this nerve
damage is often permanent.
When
a doctor has reason to believe that there
will be a large baby, Caesarean Section should
be considered.
One clue is when the mother suffers from diabetes
during the pregnancy. The increased sugar
in her blood causes the baby to grow more
than usual, resulting in a larger head and
broader shoulders. This makes it more difficult
for the child to fit through the pelvis, and
more likely that one of the shoulders will
get caught on the mother's pelvic bone, creating
the circumstances for an Erb's Palsy injury.
A sonogram may also indicate
a larger than usual baby. If the mother does not
progress quickly through the initial stages of labor,
this too can indicate a large baby. A larger baby
will not move down the birth canal as smoothly or
rapidly as a smaller one.
When this occurs, the physician should realize that
there is the possibility that the baby is too large
for normal vaginal delivery, and steps should be
taken to prepare for Caesarean Section.

By performing a Caesarean Section, the excessively
large baby does not have to pass through the narrow
birth canal, avoiding trauma from being forced into
and through the boney pelvis.
Sometimes during the delivery process, the baby’s
shoulder gets caught on the pelvic bone without
advance warning. Even when this occurs without
advance warning, permanent nerve injury is generally
preventable.
The key for the doctor is not to panic. The doctor
should not pull on the child’s head because this
can stretch or tear the nerves in the spine which
lead to the impacted shoulder.
Similarly,
the doctor should not try to push the child out
by applying pressure to the mother’s stomach. This
is like trying to force a square peg through a round
hole. If you push hard enough, you can fit a square
peg through a round hole, but only with significant
damage to the corners of the peg.
If you push on a mother’s
stomach hard enough or pull on the child’s
head hard enough, you can ultimately deliver
the child, but only after causing serious
and permanent injury.
Although
there are many acceptable maneuvers that can
be used to deliver the child without permanent
nerve damage to the shoulder and arm, many
doctors do not follow them.
Unfortunately, sometimes physicians panic,
fail to perform the appropriate maneuvers
and end up causing permanent nerve damage
by pushing the baby out from above or pulling
the baby out from below, despite the fact
that the shoulder is impacted on the pelvic
bone. When this occurs, the physician is committing
medical malpractice.
Permanent Injury
Although many children born with Erb’s Palsy
injuries recover to a significant degree,
many are often left with permanent nerve injury
to their shoulder and arm. The arm can be
weaker and shorter than the other arm, atrophied,
and the shoulder deformed. In some cases the
nerve damage is so severe that surgery is
necessary.
To
learn more about Erb's Palsy, please visit
our links page. It contains links to Erb's Palsy websites.
If you, a family member or loved one has sustained
Erb's Palsy injury and wish to discuss your
legal rights please feel to call us toll free
at 1-888-MEDLAW1.
______________________
Bonina & Bonina, P.C.
is a sustaining participant of the National
Brachial Plexus/Erb's Palsy Association
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