The Long-Term Cost of Birth Injuries

Birth injuries resulting from medical negligence present a significant cost to mothers, babies, the NHS, and society as a whole. As birth injury claims specialists, we focus on getting our clients the rehabilitation and compensation they need to recover. However, with regard to the social cost of medical negligence claims, it is worth noting that a recent report from NHS Resolution, the body that handles NHS claims, shows that in England, payments for clinical negligence in the NHS rose by 9.5% in 2022/23 to almost £2.7 billion. Maternity care negligence accounts for a sizeable portion of this figure.

Birth injuries are injuries caused to a mother and/or infant before, during, or soon after labour. Examples of injuries that can affect the mother include:

• Perineal trauma
• Haemorrhage
• Infection
• Ruptured uterus
• Prolapsed uterus
• Broken pelvis
• Pre-eclampsia

Babies can also suffer a range of birth injuries, including:

• Cerebral palsy
• Brachial plexus birth injury (for example, Erbs palsy, also known as shoulder dystocia)
• Oxygen starvation (Anoxia or Hypoxia)
• Brain injury
• Broken bones
• Infection
• Stillbirth

Although most women and babies receive exemplary care from the NHS when giving birth, the above injuries can be caused by negligence. This can result in an enormous physical and mental health cost to the victim.

The ongoing effects of brachial plexus birth injury

Let us take as an example, brachial plexus birth injury, one of the most common types of birth injuries in infants. A brachial plexus birth injury is damage to the brachial plexus nerves during childbirth. The brachial plexus is a network of nerves that controls the shoulder, arm, and hand muscles. These nerves originate from the spinal cord in the neck and extend into the upper extremities.

During childbirth, the brachial plexus can be stretched or injured if there is excessive pulling or pressure on the baby’s head and neck. This can happen in cases of complicated deliveries, especially when there are complications such as shoulder dystocia. Shoulder dystocia occurs when the baby’s head passes through the birth canal, but the shoulders become stuck behind the mother’s pelvic bone.

The severity of brachial plexus birth injuries can vary. In most cases, the infant will fully recover. However, a 2023 paper that focused on the breadth of impact of brachial plexus birth injuries found that in approximately 30% of cases, affected children have permanent paralysis leading to secondary complications, including persistent weakness, contractures, joint deformity/dislocation, and altered limb growth. In addition, those surveyed stated that their brachial plexus birth injury resulted in other health complications, including pain and range of motion concerns, strength concerns, mental health conditions, nerve symptoms, muscular symptoms, joint inflammation/degeneration, and spinal conditions. The study concluded that whilst the primary focus for children with a brachial plexus birth injury should be on improving physical musculoskeletal function, wider impacts that can span into adulthood should not be ignored. A Birth Injury Compensation Solicitor will ensure expert witnesses are instructed so the Court can properly assess the Claimant’s long-term prognosis to ensure an accurate quantum of damages is awarded.

The long-term impact of a perineal tear

For mothers, one of the most common birth injuries is a perineal tear, which can be categorised into the following degrees of severity:

• First-degree tear: Involves only the perineal skin and underlying superficial tissues, may necessitate stitches, and typically heals quickly.
• Second-degree tear: Affects the perineal muscles but not the anal sphincter; these tears usually require stitches and tend to heal effectively.
• Third-degree tear: Extends into the anal sphincter, necessitating careful surgical repair to ensure proper healing and function.
• Fourth-degree tear: The most severe type, extending through the anal sphincter and into the mucous lining of the rectum. Surgical repair is essential; complications such as faecal incontinence may arise if not effectively managed.

Incorrect identification of the severity of perineal injury and missed third degree tears can have devastating long-term consequences for women, affecting their physical health, sex life, and psychological well-being. It is vital; therefore, a Birth Injury Compensation Solicitor identifies what caused the tear, any risk factors the midwife did not spot, and the long-term consequences of the injury. Again, expert evidence will play a key role in determining the extent and causation of the injury and the prognosis.

Government inquiry into birth trauma

Birth injuries normally coincide with birth trauma. On 9 January 2024, a new All-Party Parliamentary Group (APPG) was launched to investigate birth trauma in the UK. The inquiry will look at the reasons for traumatic births (which may or may not result in a birth injury) to develop new policies to bring the number of birth trauma cases down.

Specifically, the inquiry aims to:

• Identify standard features in maternity care (before, during labour and birth, and after) that contribute to birth trauma
• Highlight good practice, both in the quality of maternity care and in providing support to women who have had traumatic birth experiences and
• Look at the impact of birth trauma on women’s relationships, ability to bond with their babies and future decision-making.

Evidence is expected to be heard over several inquiry sessions between February and March 2024, with the inquiry reporting in April 2024.

Final words

Giving birth should be a safe experience that is remembered for the joy of a healthy baby and mother leaving the hospital as a family. If the mother and/or baby experience a birth injury (and related trauma), what should be the beginning of a happy time can swiftly turn into a nightmare of pain, worry, and endless medical appointments.

If you have experienced a birth injury, it is crucial to contact a Birth Injury Solicitor as soon as possible. Around 80% of all clinical negligence claims are settled outside of Court, so please be assured that you will unlikely have to face the stress of a trial. What is important is that you get the funds and support you and your baby need to recover as best as possible and put the event behind you.

Our team has decades of combined experience in successfully advising and representing clients in medical negligence cases relating to birth injuries. We are sympathetic and understanding and are here to help you every step of the way.

Contact us today to discuss your claim.