What is birth asphyxia?
The term asphyxia refers to lack of oxygen. Birth asphyxia occurs when a baby is deprived of oxygen before, during or shortly after labour. Without oxygen, a baby’s cells cannot work properly and waste products (acids) build up, resulting in acidosis which can cause permanent damage. Severe birth asphyxia can lead to anoxia or hypoxia; anoxia occurs when there is no oxygen in the brain or muscles, and hypoxia is when only a small amount of oxygen is present.
The consequences of birth asphyxia can be permanent and devastating. Brain damage can occur even if your baby only stops breathing for a few minutes. If your baby experiences anoxia or hypoxia, they may develop cerebral palsy or Hypoxic-ischemic encephalopathy (HIE). HIE can manifest itself in multiple ways including learning disabilities, behavioural problems, epilepsy or seizures, motor impairment or developmental delay.
What causes birth asphyxia?
The longer and more difficult a delivery is, the greater the chances of birth asphyxia occurring in a newborn. Birth asphyxia can be caused by a number of complications before, during and after labour. These include:
- The umbilical cord dropping in front of the baby in the birth canal - If the cord becomes pinched or pressed tightly against the wall of the vagina, birth asphyxia can occur as a result of reduced blood flow to the baby. This is because babies don’t actually breathe until after birth, they receive all of their oxygen via the umbilical cord.
- Lack of amniotic fluid or waters ‘breaking’ too early - Amniotic fluid acts a cushion for both the baby and the umbilical cord. If there is insufficient fluid or the amniotic membrane breaks prematurely, it can put great pressure on the infant during birth.
- Anaemia - If a foetus is suffering from iron deficiency, it may result in birth asphyxiation as oxygen cannot be adequately transported in the baby’s red blood cells. Birth asphyxia can also occur if the mother suffers from anaemia during pregnancy.
- Meconium Aspiration Syndrome – If a baby becomes stressed and defecates in the womb, they can breathe in meconium (a dark green substance forming a newborn’s first faeces). This can cause birth asphyxia in the infant.
- Infection – If the mother develops an infection during pregnancy or labour birth asphyxia can occur.
- Cephalopelvic disproportion (CPD) – CPD occurs when the baby’s head is too large to travel through the birth canal or the baby presents in a way that makes it difficult for it to move through normally (such as a breach birth). This increases the risk of birth asphyxia occurring for a number of reasons including: infant distress and umbilical cord prolapse. Also, prolonged labour increases the chances of health professionals having to use intervention to assist the labour or deliver the baby quickly.
- Placenta previa – This condition happens when the placenta covers the cervix during growth. If undetected it can lead to can lead to foetal hypoxia (as well as being fatal to the mother).
Other causes of birth asphyxia in newborns can include; the baby’s lungs not developing properly, the mother suffering from high or low blood pressure, the placenta separating from the uterus too soon and the infant’s airways being blocked.
How can birth asphyxia be prevented?
The two most important factors in preventing oxygen deprivation during labour are:
- Monitoring the mother and infant carefully throughout labour to ensure problems such as foetal distress are quickly recognised; and
- Quickly delivering the infant if foetal distress or other complications occur.
It is also vital that mother and baby are monitored throughout the pregnancy so that signs of CPD, pre-eclampsia, placenta previa, anaemia and/or other complications are picked up immediately so early delivery can be planned and carried out if required.
The reason why a baby’s heart rate is regularly monitored throughout pregnancy (especially during the third trimester) and during labour is because this provides the first signal that something may be wrong. If a baby is experiencing lack of oxygen to the brain, their heart rate will present as ‘non-reassuring’. If this occurs, action should be taken immediately by health professionals and preparations for an emergency C-section should be made.
How common is birth asphyxia?
It is estimated that around 1,200 babies are starved of oxygen at birth every year in the UK and approximately one million newborns die as a result of severe birth asphyxia every year worldwide. It is the most common cause of infant mortality according to the World Health Organisation (WHO).
What are the signs or symptoms of birth asphyxia?
The symptoms of asphyxia in newborns before birth include abnormal foetal heart rate and low pH levels, indicating too much acid. When the baby is delivered it may be not breathing or struggling to breathe, have a poor skin colour, be non-responsive, a weak heart rate and/or meconium stained amniotic fluid.
Symptoms are often reflected in a low Apgar score. This is the test given to newborns one to five minutes after birth.
The scoring system has five factors:
- response to stimulus
- muscle tone
Each factor gets a score of 0, 1, or 2. The highest overall score possible is 10. A baby with a lower Apgar score has a higher risk for birth asphyxia. A score lower than 7 can indicate that a baby doesn’t have enough oxygen. The doctor may suspect your baby has asphyxia if they have an Apgar score of 3 or lower for more than five minutes.
What are the differences between mild, moderate and severe birth asphyxia?
The severity of birth asphyxia depends on how long the baby was deprived of oxygen. A newborn can suffer from mild, moderate or severe asphyxia.
Mild birth asphyxia
Babies who have suffered from mild birth asphyxia often recover fully with no long-term health effects. After the birth they are given support with their breathing and then monitored closely.
Moderate birth asphyxia
Often infants who have suffered moderate birth asphyxia will make a full recovery, if adequate treatment is given competently and quickly. However, some suffer from long-term side-effects such as learning disabilities.
Severe birth asphyxia
In cases of severe oxygen deprivation at birth, a newborn will usually develop hypoxic ischemic encephalopathy (HIE) soon after delivery. HIE is a brain injury that can lead to conditions such as cerebral palsy, permanent brain damage and damage to the internal organs such as the kidneys and liver.
Babies with HIE may have the following symptoms:
- Hypotonia (baby is limp and floppy)
- Poor feeding
- Depressed level of consciousness (the baby is not alert)
- Multiple organ problems (involvement of the lungs, liver, heart, intestines,
- Poor brain stem reflexes (breathing problems, an abnormal response to light, blood pressure and heart problems)
In cases of severe birth asphyxia, doctors may try cooling therapy to prevent long-term damage to the newborn’s brain. By cooling the body (a technique called therapeutic hypothermia) to reduce brain temperature, doctors can alter the chemical processes that lead to brain damage. As soon as possible after birth, and with strict controls in place, the baby is cooled with a purpose made cap or with a special blanket or mattress. After about three days, the baby is gradually warmed again. However, cooling treatment may cause problems of its own including problems with blood pressure control, abnormal heart rhythm, bleeding / clotting problems, and chemical & sugar imbalances in the blood. Your doctor should explain the risks of the treatment fully before he or she proceeds.
Can I claim compensation for birth asphyxia?
You may be able to make a claim for birth asphyxia in a newborn if you can show that it resulted from the negligent actions and/or admissions of health professionals.
To show negligence, you must prove, on the balance of probabilities, that:
- the health professional/s owed you a duty of care;
- they breached that duty
- the breach resulted in damage (i.e. complications from birth asphyxia).
To help establish negligence, your solicitor will consult your child’s medical records and may engage an expert witness to testify that the standard of care provided to your family was below what would be expected of a competent health professional working in the same circumstances.
How much compensation will I get?
The amount of compensation you will receive greatly depends on the extent of the physical and/or mental injury your baby suffered as a result of being deprived of oxygen at birth. If your newborn suffered severe brain damage or cerebral palsy during birth, he or she may need lifelong care and support, which will have a drastic effect on your life as a parent. In these types of cases, settlements have amounted to millions of pounds, to reflect the significant cost of providing round the clock care to a child for the rest of his or her life.
What is the process of making a claim?
Firstly, you need to instruct an experienced birth injury solicitor, who will listen to your case and establish whether or not you have grounds to make a claim of negligence. The team at IBB Law can assist you with evaluating whether or not you have a chance of successfully claiming compensation. We understand that infant birth injuries can be distressing and you can be assured we will evaluate your case in a sensitive, compassionate manner.
We will build the case for negligence and then write to the NHS Trust or authority responsible for the hospital in which you gave birth, stating that you are making a claim on behalf of your child for complications due to birth asphyxia.
The relevant authority will have 90 days to conduct its own investigation into the matter, and either concede that there was negligence or challenge the claim. If the claim is challenged, we will issue court proceedings as soon as possible.
How long with the process take?
It depends on the complexity of your case and the severity of injury to your baby.
Will I have to go to court?
If the Authority contests the claim, then your solicitor will file proceedings in court. In most cases, claims settle before the court date. At IBB Law, we understand how traumatic attending court is for parents of a child injured because they were negligently deprived of oxygen at birth. Therefore, we strive to obtain a settlement outside of formal litigation. If you are required to attend court, we will provide you with support and guidance.
How much will it cost to make a claim?
At IBB Law we provide ‘conditional fee arrangements’, otherwise known as ‘no win, no fee’. This means that if your claim is unsuccessful, you will not have to pay any legal fees to our solicitors.
Because we are shouldering the risk of your claim, you can therefore feel confident that we believe it has prospects of success.
You can further protect yourself by taking out insurance to cover the other side’s costs if the court orders that you must pay them.
We will fully explain all your options to you when you come in to see us.
If you would like further information on making a compensation claim for your complications resulting from birth asphyxia, please call our office on 0333 123 9099 or email email@example.com.