Common Birth Injuries in Upstate New York

The moment a baby is born should be filled with joy and relief. But for some families across Upstate New York, complications during labor and delivery can result in injuries that change everything. Understanding what these injuries are, why they happen, and what resources exist can help families navigate an incredibly difficult situation.

What Counts as a Birth Injury?

Birth injuries are physical harm that occurs to a baby during labor or delivery. These aren’t genetic conditions or developmental disabilities that existed before birth—they’re injuries that happen specifically because of the mechanics of delivery or oxygen deprivation during the birthing process.

Some injuries are relatively minor and heal completely within weeks. Others can result in permanent disabilities that affect a child for their entire life. The difference often comes down to which part of the body is injured and how severely.

How Common Are Birth Injuries in New York?

New York State doesn’t publish specific “birth trauma rates” for individual counties or regions, but the Department of Health tracks several related indicators that paint a picture of neonatal health across the state.

Currently, New York sees a neonatal mortality rate of 2.8 deaths per 1,000 live births. About 9.2% of babies are born prematurely, and roughly 115 out of every 10,000 deliveries involve severe maternal complications that can increase risks to the baby.

What’s particularly relevant for Upstate families is that regions like the Mohawk Valley, Central New York, and Western New York tend to report slightly higher infant morbidity rates compared to New York City. This difference isn’t about the quality of medical care—it’s largely about access. Many rural and upstate counties lack Level III Neonatal Intensive Care Units (NICUs), which are equipped to handle the most fragile newborns, especially those with very low birth weights or complex medical needs.

Hypoxic-Ischemic Encephalopathy

One of the most serious birth injuries is hypoxic-ischemic encephalopathy, or HIE. This happens when a baby’s brain doesn’t get enough oxygen during delivery. It affects somewhere between 1 and 3 out of every 1,000 births.

When the brain is deprived of oxygen, even for a relatively short time, brain cells begin to die. Babies with HIE might have seizures shortly after birth, show poor muscle tone, or have difficulty breathing on their own. The long-term effects can include cerebral palsy, developmental delays, learning disabilities, or in severe cases, death.

HIE can happen for several reasons. Prolonged labor puts stress on the baby. If the umbilical cord gets compressed or wrapped around the baby’s neck, oxygen flow is restricted. Placental abruption—when the placenta separates from the uterine wall too early—cuts off the baby’s oxygen supply. Maternal conditions like high blood pressure or diabetes can also contribute to oxygen deprivation.

The timing of intervention matters enormously with HIE. When medical teams recognize signs of fetal distress and respond quickly, outcomes improve dramatically. Therapeutic hypothermia—a treatment where the baby’s body temperature is lowered for several days after birth—has been shown to reduce brain damage in babies with HIE, but it needs to be started within the first six hours of life.

Brachial Plexus Injuries

The brachial plexus is a network of nerves that runs from the spine through the neck and into each arm. These nerves control movement and sensation in the shoulder, arm, and hand. During a difficult delivery, especially when a baby’s shoulder gets stuck behind the mother’s pubic bone (something called shoulder dystocia), these nerves can be stretched, compressed, or in severe cases, torn.

Erb’s palsy is the most common type of brachial plexus injury. It affects the upper nerves (C5 and C6) and typically causes weakness or paralysis in the shoulder and upper arm. A baby with Erb’s palsy might not be able to move their arm away from their body or rotate it properly. The hand usually still works normally.

Klumpke’s palsy is less common and affects the lower nerves. It impacts the forearm and hand more than the shoulder.

Many babies with brachial plexus injuries recover fully with physical therapy, especially when the injury is mild. But research shows that about 20-25% of cases result in some degree of permanent disability. The difference usually comes down to how severely the nerves were damaged—stretched nerves can heal, but torn nerves often cannot without surgical repair.

Bleeding in and Around the Brain

Several types of bleeding can occur in a newborn’s brain or in the spaces surrounding it. These intracranial hemorrhages vary widely in severity depending on where the bleeding occurs and how much blood accumulates.

Subdural hemorrhages involve bleeding between the brain and the tough outer membrane that covers it. Subarachnoid hemorrhages occur in the space beneath that membrane. Intraventricular hemorrhages happen inside the brain’s fluid-filled chambers and are particularly common in premature babies. Cerebellar hemorrhages affect the part of the brain that controls coordination and balance.

These hemorrhages are often related to the stresses of delivery. Prolonged labor, the use of vacuum extractors or forceps, or very rapid deliveries can all increase the risk. Premature babies face higher risks because their blood vessels are more fragile and more likely to rupture.

In some cases, small hemorrhages resolve on their own without causing lasting problems. But significant bleeding can lead to seizures, increased pressure inside the skull, hydrocephalus (a buildup of fluid in the brain), or permanent neurological damage.

Broken Bones During Birth

Bone fractures during delivery are more common than many people realize, though most heal remarkably well. The clavicle—the collarbone—is the most frequently broken bone, occurring in roughly 2-4% of all term births.

Clavicle fractures typically happen when a baby’s shoulder needs to be manipulated to help them pass through the birth canal. You might hear a grinding or crackling sound during delivery, or notice that the baby isn’t moving one arm as much as the other in the hours after birth. Sometimes the fracture isn’t identified until a small lump forms as the bone begins to heal.

The good news is that clavicle fractures in newborns almost always heal completely within a few weeks, usually without any treatment beyond gentle handling. The bones of newborns are remarkably flexible and repair themselves quickly.

Longer bones like the femur or humerus can also break during delivery, though this is less common. These fractures are more likely when a baby is particularly large (a condition called macrosomia), positioned abnormally (like breech), or during particularly difficult deliveries.

Swelling and Blood Collection on the Scalp

Several types of swelling can occur on a baby’s head during delivery, and while they can look alarming, most are harmless and temporary.

Caput succedaneum is swelling of the soft tissues of the scalp. It’s caused by pressure on the head as the baby moves through the birth canal and typically crosses over the skull’s suture lines (the natural joints between skull bones). This swelling is mostly fluid and usually disappears within a few days without any treatment.

Cephalohematoma is different—it’s a collection of blood between the skull bone and the membrane that covers it. Unlike caput succedaneum, a cephalohematoma doesn’t cross suture lines because it’s located underneath them. These are more common after vacuum-assisted deliveries. Cephalohematomas can take weeks or even months to fully resolve as the body slowly reabsorbs the blood. In rare cases, they can contribute to jaundice as the accumulated blood breaks down.

Subgaleal hemorrhage is the most dangerous type of head bleeding in newborns. This occurs in a space beneath the scalp that can potentially hold 40-100% of a baby’s entire blood volume. The bleeding can cause a baby to go into shock from blood loss, and the mortality rate is as high as 25%. Subgaleal hemorrhages are strongly associated with vacuum-assisted deliveries and require immediate, aggressive medical intervention.

Facial and Spinal Nerve Damage

During delivery, pressure on a baby’s face or neck can sometimes injure delicate nerves. Facial nerve palsy—weakness or paralysis of the facial muscles—can occur if the facial nerve gets compressed during birth. This might happen from pressure during delivery or from the use of forceps. In most cases, facial nerve injuries resolve on their own within a few weeks as the nerve heals.

Spinal cord injuries during birth are rare but devastating. They can occur if excessive traction is applied to the baby’s head during delivery, particularly in breech presentations. The spinal cord can be stretched, torn, or even severed. These injuries have an approximately 90% mortality rate, and survivors typically face severe, permanent disabilities.

Why These Injuries Happen More Often in Some Areas

Several factors contribute to higher rates of birth injuries in parts of Upstate New York compared to more urban areas with large medical centers.

Access to specialized care makes a significant difference. When a pregnancy becomes complicated or a delivery becomes difficult, having immediate access to a Level III NICU and maternal-fetal medicine specialists can be lifesaving. Many rural hospitals simply don’t have these resources on-site, and transferring a mother or baby during an emergency takes precious time.

Prenatal care also plays a role. While 81% of pregnant people in New York State begin prenatal care in their first trimester, that percentage drops in certain communities, particularly among low-income families and some minority populations. Regular prenatal visits allow doctors to identify risk factors early—like gestational diabetes, high blood pressure, or a baby measuring larger than average—and plan accordingly.

Maternal health conditions that are increasingly common, including diabetes, hypertension, and obesity, all raise the risk of complications during delivery. These conditions can lead to larger babies, longer labors, and increased need for intervention, all of which contribute to injury risk.

What Puts a Baby at Higher Risk

Certain situations are known to increase the likelihood of birth injuries. Understanding these risk factors doesn’t mean an injury is inevitable, but it does mean that extra monitoring and preparedness make sense.

Macrosomia, when a baby weighs more than 8 pounds, 13 ounces at birth, substantially increases the risk of shoulder dystocia and the brachial plexus injuries that can result. Babies of mothers with diabetes are more likely to be larger, even if the diabetes is well-controlled.

Prolonged labor puts stress on both mother and baby. The longer a baby spends in the birth canal, the higher the risk of oxygen deprivation, nerve compression, and other mechanical injuries.

Abnormal fetal positioning—particularly breech presentation (feet or bottom first) or transverse positioning (sideways)—makes delivery more complicated and increases injury risk.

The use of instruments like forceps or vacuum extractors, while sometimes necessary, increases the risk of certain injuries including facial nerve damage, skull fractures, and intracranial hemorrhages.

Premature birth means a baby’s body is more fragile overall. Their blood vessels are more delicate, their bones are softer, and they’re less able to tolerate the stresses of delivery.

Older maternal age, particularly over 35, is associated with higher rates of complications during pregnancy and delivery, including conditions that can lead to birth injuries.

The use of labor-inducing or labor-augmenting medications like oxytocin (Pitocin) can make contractions stronger and more frequent, which sometimes contributes to fetal distress or rapid deliveries that increase injury risk.

Getting Help After a Birth Injury

If a baby in New York sustains a birth injury, families aren’t on their own. The state provides automatic eligibility for the Early Intervention Program, a federal initiative (Part C) that provides services for children from birth to age three who have developmental delays or disabilities.

Early Intervention can include physical therapy to help with movement and motor skills, occupational therapy to work on daily living skills and fine motor development, speech therapy, and various specialized medical services. The program also provides support for families, helping parents understand their child’s condition and learn how to advocate effectively for their needs.

According to state data, more than 85% of families participating in Early Intervention report that the services helped them better understand their child’s needs and feel more capable of supporting their development. These services are designed to be provided in natural settings—often in the family’s home—and are tailored to each child’s specific needs.

Preventing Birth Injuries

While not all birth injuries can be prevented, medical research has identified several strategies that significantly reduce risk.

Proper management of shoulder dystocia is critical. When a baby’s shoulder becomes stuck, medical teams need to follow evidence-based protocols rather than simply pulling harder. Specific maneuvers can help release the shoulder without causing brachial plexus injuries.

Judicious use of vacuum extractors and forceps makes a difference. These tools can be necessary in certain situations, but they should be used only when the potential benefit outweighs the risks, and they should be used by experienced practitioners who understand proper technique.

Universal screening and management of gestational diabetes helps identify mothers whose babies might be growing larger than average, allowing for planning and potentially earlier delivery to avoid complications from macrosomia.

Continuous fetal monitoring during labor allows medical teams to identify signs of distress early. When a baby’s heart rate shows concerning patterns, quick action—including emergency cesarean delivery when necessary—can prevent oxygen deprivation injuries.

Careful timing of labor induction matters. While induction is sometimes medically necessary, unnecessary or poorly timed inductions can lead to complications. The decision to induce should be based on clear medical indications and a thorough assessment of risks and benefits.

Moving Forward

For families dealing with a birth injury, the first days and weeks can feel overwhelming. There are medical appointments, therapy sessions, specialists to see, and a constant stream of new information to absorb. It’s a lot to process while also trying to bond with and care for a new baby.

But families across Upstate New York aren’t navigating this alone. Healthcare providers, early intervention specialists, support groups, and community resources exist to help. Understanding what happened, why it happened, and what comes next is the first step toward getting a child the support they need to thrive.

Birth injuries carry real weight—medical, emotional, and practical. The information here is meant to help families understand the landscape, ask informed questions, and know what resources exist. Every child’s situation is unique, and the best path forward always involves working closely with qualified medical professionals who understand the specifics of that particular case.