Common Birth Injuries in Upstate New York

Every year, thousands of families across Upstate New York navigate the unexpected reality of a birth injury. While most deliveries proceed without complications, understanding what can go wrong and why helps families recognize problems early and access the support they need.

This guide breaks down the most common birth injuries occurring in our region, what the data tells us about risk factors, and what these diagnoses actually mean for daily life.

What Are Birth Injuries and How Do They Happen During Delivery?

Birth injuries are physical harm to a baby that occurs during labor and delivery. These aren’t the same as birth defects, which develop during pregnancy. Birth injuries happen during the actual process of being born, often during complicated or high-risk deliveries.

These injuries can affect different parts of a newborn’s body:

• Nerves that control arm and shoulder movement
• Bones, particularly the collarbone and skull
• The brain, especially when oxygen supply is disrupted
• Facial nerves and soft tissue
• Blood vessels under the scalp

Some birth injuries heal completely within weeks. Others result in permanent conditions requiring ongoing therapy, medical care, and lifestyle adjustments.

The distinction matters because birth injuries are often preventable with proper monitoring, timely intervention, and appropriate delivery techniques.

How Common Are Birth Injuries in New York State?

New York tracks severe maternal morbidity (SMM), which includes serious complications during delivery that can increase the risk of injury to both mother and baby. The state’s SMM rate sits at approximately 2.7%, or 271 per 10,000 deliveries. That translates to roughly 1 in 37 deliveries experiencing serious complications.

These aren’t just statistics. Each number represents a family whose birth experience included intensive care, extended hospital stays, or long-term health challenges.

Within Upstate New York specifically, regional variations paint an important picture. The 2018 data shows significant differences across regions, measured per 10,000 deliveries:

• Finger Lakes: 90
• Southern Tier: 201
• Central NY: 219
• Capital Region: 238
• Western NY: 244
• North Country: 270

These regional differences reflect variations in hospital resources, access to specialized obstetric care, and demographic factors that influence birth outcomes.

Which Birth Injuries Occur Most Frequently in Upstate New York?

Understanding the specific types of injuries helps families know what signs to watch for and what questions to ask medical providers.

Brachial Plexus Injuries and Erb’s Palsy

The brachial plexus is a network of nerves running from the spine through the shoulder and down the arm. When these nerves stretch, tear, or compress during delivery, the baby may lose movement or sensation in one arm.

Erb’s palsy, the most recognized brachial plexus injury, typically affects the upper arm and shoulder. You might notice that a baby:

• Keeps one arm straight and turned inward against their body
• Doesn’t move one arm when startled or reaching
• Has a weakened grip on the affected side

These injuries most commonly occur during shoulder dystocia, when a baby’s shoulder becomes stuck behind the mother’s pelvic bone after the head has already delivered. The condition creates an emergency requiring immediate action, and sometimes that urgency results in nerve damage.

Some brachial plexus injuries resolve within three to six months as nerves heal. Others require physical therapy, and severe cases may need surgical intervention to repair or graft damaged nerves.

Broken Clavicle and Other Bone Fractures During Birth

The clavicle, or collarbone, is the most frequently fractured bone during delivery. Its location makes it vulnerable during difficult births, particularly when:

• The baby is larger than average
• Delivery requires forceps or vacuum extraction
• Shoulder dystocia occurs
• The baby is in breech position

A fractured clavicle might not be immediately obvious. Signs include:

• The baby crying when the affected side is touched or moved
• Not moving one arm as much as the other
• A small bump forming along the collarbone as it heals

The good news is that newborn bones heal remarkably well. Most clavicle fractures heal completely within weeks with gentle handling and minimal intervention. The area may need to be immobilized, but long-term complications are rare.

Other bone fractures, including to the skull or limbs, are less common but can occur during particularly difficult instrument-assisted deliveries.

Hypoxic Ischemic Encephalopathy and Brain Injury From Oxygen Deprivation

Hypoxic ischemic encephalopathy (HIE) represents one of the most serious birth injuries. It occurs when a baby’s brain doesn’t receive enough oxygen before, during, or immediately after birth.

The brain is extraordinarily sensitive to oxygen levels. Even brief deprivation can damage or kill brain cells, leading to:

• Cerebral palsy
• Developmental delays
• Seizure disorders
• Learning disabilities
• Motor function impairments

HIE can result from various complications:

• Umbilical cord problems (prolapse, compression, or tight wrapping around the neck)
• Placental abruption
• Uterine rupture
• Maternal blood pressure emergencies
• Prolonged or arrested labor

Babies with HIE may initially appear floppy or unresponsive, have difficulty feeding, experience seizures, or show abnormal reflexes. Severe cases are usually apparent immediately, while milder cases might not become evident until developmental milestones are missed.

Therapeutic hypothermia, or cooling therapy, has become standard treatment when HIE is identified quickly. This involves carefully lowering the baby’s body temperature for 72 hours to slow the injury process and minimize brain damage.

Cerebral Palsy Caused by Birth Complications

Cerebral palsy (CP) describes a group of disorders affecting movement, muscle tone, and posture. While not all cerebral palsy stems from birth injury, research indicates that approximately 30% of cases are associated with complications during labor and delivery.

Birth-related cerebral palsy typically results from brain damage caused by:

• Oxygen deprivation (hypoxia)
• Bleeding in the brain
• Severe untreated jaundice
• Infections during delivery
• Physical trauma to the baby’s head

Cerebral palsy exists on a spectrum. Some individuals have mild symptoms affecting only fine motor skills, while others experience significant impairments requiring lifelong assistance with daily activities.

Early signs might include:

• Missing developmental milestones like rolling over, sitting, or crawling
• Stiff or floppy muscle tone
• Favoring one side of the body
• Difficulty with coordination
• Unusual postures

There’s no cure for cerebral palsy, but early intervention with physical therapy, occupational therapy, and other supports can significantly improve quality of life and independence.

Facial Nerve Injuries From Forceps or Vacuum Delivery

Facial nerve palsy occurs when the seventh cranial nerve, which controls facial muscles, gets compressed or damaged during delivery. This most commonly happens with forceps or vacuum extraction, when instruments put pressure on the baby’s face or head.

The most noticeable sign is facial asymmetry. When the baby cries, one side of the face moves normally while the other remains still. The affected eye might not close completely, and the corner of the mouth on that side won’t pull down.

Most facial nerve injuries are temporary, resolving within a few weeks as swelling decreases and the nerve recovers. Eye protection may be needed if the baby can’t fully close the affected eye, preventing dryness and irritation.

Persistent facial palsy beyond three months may require specialized evaluation and possibly surgery to restore nerve function.

Skull Fractures and Cephalohematoma From Delivery Trauma

A cephalohematoma is a collection of blood between a baby’s skull bone and the fibrous covering around it. Unlike the generalized swelling that many newborns experience, a cephalohematoma is a firm, raised bump that doesn’t cross the skull’s suture lines.

These injuries typically result from:

• Vacuum extraction
• Forceps delivery
• The baby’s head pressing against the mother’s pelvis during prolonged labor
• Assisted delivery in a baby with a large head

A cephalohmatoma might not appear immediately after birth. The swelling often becomes more pronounced over the first day or two.

While cephalohematomas generally resolve on their own over weeks to months, they can cause complications:

• Prolonged jaundice: As the collected blood breaks down, it releases bilirubin, which can overwhelm a newborn’s immature liver. This sometimes requires phototherapy treatment.
• Infection: Though rare, the blood collection can become infected.
• Anemia: Large blood collections may contribute to low red blood cell counts.
• Skull fracture: In some cases, a cephalohematoma accompanies an underlying skull fracture.

Doctors monitor these carefully but rarely intervene directly unless complications develop.

Injuries From Vacuum Extraction and Forceps Delivery

Instrument-assisted deliveries using vacuum extractors or forceps sometimes become necessary when:

• Labor stalls during pushing
• The baby shows signs of distress
• The mother has a medical condition making prolonged pushing dangerous

While these tools can facilitate necessary deliveries, they also carry risks of soft tissue injuries including:

• Extensive bruising and swelling on the scalp
• Caput succedaneum (fluid swelling that crosses suture lines)
• Scalp lacerations or abrasions
• Subgaleal hemorrhage (bleeding in a dangerous space beneath the scalp)
• Eye trauma or hemorrhages

Most vacuum and forceps injuries are superficial and resolve without treatment. However, subgaleal hemorrhage represents a medical emergency, as the space involved can hold a significant portion of a newborn’s blood volume.

How Cesarean Delivery Affects Birth Injury Risk in New York

The relationship between cesarean sections and birth injuries is complex. C-sections prevent some birth injuries while potentially introducing others.

New York data shows that adverse outcomes, including severe maternal morbidity, injury, or death, occur approximately three times more often with cesarean deliveries compared to vaginal births.

This doesn’t mean cesarean sections cause most problems. The statistic reflects that C-sections are more likely when complications already exist. High-risk situations requiring cesarean delivery inherently carry elevated risk regardless of delivery method.

However, timing matters enormously. An appropriately timed cesarean section can prevent brain injury from prolonged oxygen deprivation or trauma from an impossible vaginal delivery. Conversely, delaying a necessary C-section can allow preventable injury to occur.

Cesarean delivery itself can cause:

• Surgical cuts to the baby (though rare with careful technique)
• Breathing problems if performed before 39 weeks without medical indication
• Delayed bonding and breastfeeding initiation

The decision about delivery method should always weigh specific medical circumstances against risks and benefits.

Racial and Geographic Disparities in Birth Outcomes Across Upstate New York

The data from Upstate New York reveals troubling patterns that affect which families face higher birth injury risk.

Racial Inequities in Maternal and Newborn Outcomes

Black mothers in Upstate New York experience severe maternal morbidity at approximately 2.3 times the rate of white mothers. This disparity persists even when controlling for education, income, and insurance status.

These differences stem from multiple intersecting factors:

• Implicit bias in medical care: Studies show that Black patients’ reports of pain and symptoms are sometimes dismissed or minimized.
• Different treatment patterns: Research documents that medical interventions are offered or applied differently based on patient race.
• Chronic stress from discrimination: The cumulative effect of experiencing racism creates physiological changes that affect pregnancy outcomes.
• Neighborhood factors: Residential segregation means some communities have less access to quality prenatal care, healthy food, and safe spaces for physical activity.

Hispanic mothers in Upstate New York also experience elevated rates of complications, though patterns vary by specific origin and immigration status.

These aren’t genetic differences. They’re the measurable health impact of systemic inequity.

Higher Risk for Medicaid Recipients

Families receiving Medicaid coverage experience higher rates of birth complications across Upstate New York. This reflects the reality that Medicaid serves populations facing:

• Economic instability affecting nutrition, housing, and stress levels
• Transportation barriers limiting prenatal care access
• Higher rates of chronic health conditions
• Less flexibility to take time off work for medical appointments

Additionally, not all medical practices accept Medicaid, potentially limiting where families can receive care.

How Preterm Birth and Low Birth Weight Contribute to Injury Risk

New York’s maternal and child health data shows that preterm birth (before 37 weeks) and low birth weight remain significant contributors to birth-related complications and long-term disability.

Babies born early face increased vulnerability because:

• Their organs, including the brain, haven’t fully developed
• They have less body fat and struggle to maintain temperature
• Their immune systems can’t fight infection as effectively
• Lungs may not be ready to breathe air

Preterm babies are more susceptible to:

• Intraventricular hemorrhage (bleeding in the brain)
• Periventricular leukomalacia (damage to white matter in the brain)
• Respiratory distress requiring ventilation
• Infections including sepsis

Very low birth weight infants (under 3.3 pounds) require the specialized care available in advanced neonatal intensive care units. Access to these NICUs varies across Upstate New York, meaning some families must travel significant distances or transfer to hospitals with higher-level care.

The relationship between preterm birth and birth injury is bidirectional. Sometimes premature delivery becomes necessary because of complications that also increase injury risk. Other times, the prematurity itself creates the vulnerability.

Newborn Drug Withdrawal and Maternal Substance Use Effects

New York tracks neonatal abstinence syndrome and newborn complications related to maternal drug use through the SPARCS database. These cases have contributed to newborn complications across Upstate New York.

When babies are exposed to opioids, certain antidepressants, or other substances during pregnancy, they may experience withdrawal after birth. Symptoms include:

• Tremors and jitteriness
• High-pitched crying
• Difficulty feeding and poor weight gain
• Vomiting and diarrhea
• Seizures in severe cases

Babies experiencing withdrawal require extended hospital stays, specialized care, and sometimes medication to manage symptoms. While neonatal abstinence syndrome isn’t traditionally categorized as a birth injury, it represents a challenging start that can affect bonding, feeding, and early development.

Importantly, medication-assisted treatment for maternal opioid use disorder (using methadone or buprenorphine) represents best practice. While babies may still experience some withdrawal, this approach is safer than untreated opioid use and dramatically reduces risks of relapse, overdose, and other complications.

What Families Should Know About Prevention and Early Recognition

While not all birth injuries are preventable, many result from complications that could have been managed differently with proper monitoring and timely intervention.

Signs That Warrant Immediate Medical Attention

After returning home from the hospital, watch for:

• The baby not moving one or both arms normally
• Extreme floppiness or stiffness
• Difficulty feeding or sucking
• Unusual or absent crying
• Seizures or repetitive movements
• One side of the face not moving when crying
• Eyes not tracking or moving together
• Missing reflexes that were present earlier

Trust your instincts. You know your baby better than anyone. If something seems wrong, seek evaluation even if you can’t articulate exactly what concerns you.

The Importance of Comprehensive Prenatal Care

Consistent prenatal care throughout pregnancy allows providers to:

• Identify risk factors early
• Monitor the baby’s growth and position
• Detect complications like preeclampsia or gestational diabetes
• Plan delivery approach based on specific circumstances
• Establish relationships that facilitate better communication during labor

Barriers to prenatal care, including transportation, work schedules, insurance gaps, and provider availability, contribute to worse outcomes. New York has programs to help connect pregnant individuals with care, including Medicaid presumptive eligibility that provides immediate temporary coverage.

Questions to Ask Your Medical Team

You have the right to understand what’s happening during your delivery. Questions that can help include:

• What are the specific reasons for using forceps or vacuum extraction?
• What are the alternatives if labor isn’t progressing?
• How is my baby’s oxygen and heart rate being monitored?
• What would indicate that a cesarean section is necessary?
• What’s your hospital’s rate of birth injuries?

Healthcare providers should welcome these questions. Clear communication during labor helps everyone work toward the safest possible outcome.

Resources for Families Dealing with Birth Injuries in New York

The period after a birth injury diagnosis is overwhelming. You’re processing what happened while simultaneously learning about a medical condition, navigating insurance, coordinating appointments, and caring for your baby.

New York State Resources and Support Systems

Several New York programs specifically serve children with birth injuries and developmental challenges:

Early Intervention Program: New York’s Early Intervention Program provides services for children under age three with developmental delays or disabilities. Services may include physical therapy, occupational therapy, speech therapy, and special instruction delivered in your home or community settings. Referrals can come from anyone, including parents, and evaluation is free.

Bureau for Children with Special Health Care Needs: This program helps families access medical care, care coordination, and support services.

Department of Health Regional Offices: Each region has staff who can help connect families with local resources and programs.

Medical and Therapeutic Services

Birth injuries often require coordinated care from multiple specialists:

• Pediatric neurologists for brain injuries and seizure disorders
• Orthopedic specialists for bone and musculoskeletal issues
• Physical therapists to improve motor function and mobility
• Occupational therapists for fine motor skills and daily living activities
• Speech therapists for feeding difficulties and communication

Major medical centers across Upstate New York, including facilities in Rochester, Syracuse, Albany, and Buffalo, have specialized clinics coordinating multidisciplinary care for children with complex medical needs.

Understanding Your Legal Rights

Not all birth injuries result from medical negligence, but some do. Medical malpractice occurs when a healthcare provider’s care falls below accepted standards and causes injury.

New York law provides families with the right to:

• Access complete medical records
• Seek second opinions about diagnosis and treatment
• Consult with attorneys about whether malpractice occurred
• Pursue compensation for injuries caused by negligence

Medical malpractice cases are complex and require expert testimony establishing what care should have been provided and how the actual care deviated from standards. New York has specific time limits for filing these cases, generally within two and a half years of the injury for adults, but different rules apply for children.

If you suspect that errors during delivery contributed to your child’s injury, consulting with an attorney experienced in birth injury cases can help you understand whether you have grounds for a claim.

Moving Forward After a Birth Injury Diagnosis

Learning that your child has sustained a birth injury fundamentally changes your expectations and plans. The future you imagined shifts, often suddenly and without time to prepare.

What many families find, though, is that their capacity for adaptation, advocacy, and love expands in ways they never anticipated. That doesn’t minimize the challenges or the legitimate grief over what you expected versus what you’re facing. Both things are true.

Finding Community and Reducing Isolation

Connecting with other families who understand your experience from the inside makes an enormous difference. Both national organizations and New York-specific groups offer opportunities to find community:

• Parent-to-parent programs that match you with families who’ve navigated similar diagnoses
• Condition-specific organizations offering information, advocacy, and connection
• Social media groups where you can ask questions at 2 AM when you can’t sleep
• Local support groups meeting in person across Upstate New York

Focusing on What You Can Control

After a birth injury, much feels uncertain and outside your control. Focusing energy on areas where you do have agency helps:

• Learning about your child’s specific condition and prognosis
• Building relationships with medical providers and therapists
• Documenting everything, including medical records, expenses, and observations
• Exploring what resources and services your family qualifies for
• Taking care of your own physical and mental health

Celebrating Progress, However Small

When your child’s development doesn’t follow typical timelines, the standard milestones can feel painful rather than celebratory. Many families find meaning in recognizing smaller victories: the first time their child tracks an object with their eyes, brings their hands together at midline, or maintains head control for a few extra seconds.

Progress looks different for every child. Comparing your child to typical development charts can be discouraging. Comparing your child to where they were last month often reveals meaningful improvement.

The Bigger Picture of Birth Injury Prevention in New York

Individual families shouldn’t bear sole responsibility for preventing birth injuries. Systemic changes at hospital, policy, and societal levels can reduce overall injury rates.

Hospital Quality Improvement Initiatives

Many New York hospitals participate in quality improvement collaboratives focused on reducing preventable birth injuries through:

• Standardized protocols for monitoring during labor
• Team training in emergency procedures like shoulder dystocia management
• Better communication systems between nurses, midwives, and physicians
• Regular review of cases with unexpected outcomes
• Simulation training to practice responding to complications

Hospitals with these programs demonstrate measurably better outcomes, but implementation remains inconsistent across facilities.

Addressing Racial Inequities Through Policy and Practice

Reducing racial disparities in birth outcomes requires confronting the systems that create them:

• Implicit bias training for all perinatal healthcare providers
• Diversifying the healthcare workforce
• Ensuring respectful maternal care standards
• Community-based doula programs that provide continuous support
• Addressing social determinants like housing, nutrition, and economic stability

New York has launched initiatives targeting these factors, but progress requires sustained commitment and resources.

The Role of Transparency and Accountability

Public reporting of hospital-specific outcomes helps families make informed decisions about where to deliver and creates accountability for facilities with concerning patterns. New York publishes some of this data, but many families don’t know it exists or how to interpret it.

Stronger transparency requirements and easier-to-understand public information could empower families while motivating hospitals to maintain high standards.

Questions Families Often Have About Birth Injuries

Can birth injuries be detected before hospital discharge?

Some birth injuries, like brachial plexus damage or facial nerve palsy, are usually apparent immediately. Others, particularly mild brain injuries, may not become evident until weeks or months later when developmental delays emerge.

Hospitals conduct newborn exams before discharge, but these have limitations. Always request evaluation if you notice anything unusual after coming home.

Will my insurance cover the therapies my child needs?

Coverage varies significantly by insurance plan. New York requires insurance to cover early intervention services, and Medicaid covers comprehensive services for eligible children. Private insurance coverage depends on your specific plan.

Early Intervention services are provided regardless of insurance status or ability to pay, with fees based on a sliding scale.

How do I know if my child’s injury was preventable?

This question requires expert medical review. An attorney experienced in birth injury cases can help arrange for specialists to review the medical records and determine whether the standard of care was met.

Not all birth injuries indicate negligence. Some occur despite appropriate care. But when monitoring was inadequate, warning signs were ignored, or interventions were delayed, legal options may exist.

What if my child’s birth injury wasn’t diagnosed immediately?

Many birth injuries, particularly milder cases, aren’t identified until later when expected milestones are missed. The important thing is getting appropriate evaluation and early intervention as soon as concerns arise.

For legal purposes, New York’s statute of limitations for medical malpractice involving children is different from adult cases and generally doesn’t begin until the injury is discovered or reasonably should have been discovered.

Understanding Your Family’s Path Forward

Every birth injury case is unique. The specific diagnosis, severity, available resources, and family circumstances all shape what comes next.

What remains consistent across different situations is that families deserve accurate information, compassionate support, and access to services that help their children reach their full potential.

The data about regional variations, racial disparities, and preventable complications across Upstate New York isn’t just abstract statistics. These numbers represent opportunities for improvement, places where better monitoring, more timely intervention, or changed protocols could prevent the next family from facing what yours is experiencing.

Your family’s immediate need is understanding your child’s diagnosis and accessing care. But your experience also contributes to the larger conversation about how birth injuries happen and what changes could prevent them.

Whether you’re researching because you’re preparing for delivery, recently received a diagnosis, or seeking better understanding of a condition affecting someone you care about, knowledge helps. Understanding what happened, why it matters, and what options exist provides foundation for the decisions ahead.

The families who’ve navigated birth injuries before you consistently emphasize several truths: You’re stronger than you think. Your child will teach you more than you could imagine. The right support makes an enormous difference. And you don’t have to figure everything out today.