Every year in the United States, approximately 29,000 to 30,000 babies experience some form of birth injury during delivery. While modern obstetric care has improved significantly over the past two decades, birth injuries remain a reality that affects roughly 6 to 7 out of every 1,000 live births.

This article breaks down the ten most common birth injuries based on the latest medical data and research. Understanding these conditions can help you recognize symptoms early, ask informed questions, and know what to expect if your child receives a diagnosis.

What Exactly Is a Birth Injury and How Does It Happen?

A birth injury is physical harm that occurs to a baby during the labor and delivery process. These injuries differ from birth defects, which develop during pregnancy due to genetic or environmental factors. Birth injuries happen during the actual process of being born.

Most birth injuries result from mechanical forces during delivery. This includes pressure on the baby’s body as it moves through the birth canal, the use of delivery instruments like forceps or vacuum extractors, or complications like the baby’s shoulder becoming stuck behind the mother’s pubic bone.

Several factors increase the likelihood of birth injuries occurring:

Baby’s size, particularly when the infant weighs over 8 pounds 13 ounces (macrosomia)
Prolonged or difficult labor lasting many hours
The baby’s position in the womb, especially breech presentations
Premature birth before 37 weeks
Use of forceps or vacuum extraction during delivery
Mother’s pelvic size and shape

It’s worth noting that many birth injuries are temporary and resolve on their own within weeks or months. However, some can lead to permanent disabilities requiring lifelong care and support.

Current Birth Injury Statistics You Should Know

The numbers tell an important story about birth injuries in America today:

Birth injuries now account for 20% of all infant deaths in the United States, making them the fourth leading cause of infant mortality. This statistic highlights just how serious these injuries can be, even with modern medical technology.

Male babies experience birth injuries at a rate 35% higher than female babies. Specifically, male infants have a rate of 6.9 injuries per 1,000 births compared to 5.1 per 1,000 for females. The reasons for this difference likely relate to male babies typically being larger at birth.

Geography matters when it comes to birth injury rates. Rural areas see higher rates of birth injuries compared to urban hospitals, possibly due to differences in available resources, staffing levels, and proximity to specialized neonatal care. The Northeastern United States also shows elevated rates compared to other regions.

The good news? Birth trauma rates have declined by 27% since the early 2000s. This improvement reflects better fetal monitoring technology, refined obstetric techniques, and more judicious use of cesarean sections for high-risk deliveries.

More than 80% of birth injuries fall into the moderate to severe category rather than minor injuries that resolve quickly. This means most birth injuries require medical intervention and follow-up care.

The 10 Most Common Birth Injuries in 2025

1. Brachial Plexus Injuries and Erb’s Palsy

Brachial plexus injuries affect the network of nerves running from the spine through the shoulder and down the arm. When these nerves stretch, compress, or tear during delivery, the result is weakness or paralysis in the affected arm.

Erb’s palsy is the most common type of brachial plexus injury, affecting the upper nerves and typically causing weakness in the shoulder and elbow while the hand remains functional. More severe injuries can affect the entire arm.

This injury occurs in fewer than 1% of births but still affects approximately 12,000 babies each year in the United States. It happens most often when a baby’s shoulder becomes stuck behind the mother’s pubic bone during delivery, a situation called shoulder dystocia. The medical team must act quickly to free the shoulder, and during this process, the nerves can become damaged.

Risk factors include larger babies, gestational diabetes in the mother, and prolonged second stage of labor.

Many babies with mild brachial plexus injuries recover fully within three to six months with physical therapy. However, more severe nerve damage may require surgical intervention and can result in permanent weakness or limited range of motion.

2. Cerebral Palsy and Brain Injuries During Birth

Cerebral palsy affects approximately 1 in 345 children in the United States, making it one of the most common motor disabilities in childhood. While not all cases stem from birth injuries, oxygen deprivation or trauma during delivery accounts for a significant portion.

This condition results from damage to the developing brain that affects muscle tone, movement, and posture. The severity varies enormously. Some people with cerebral palsy have mild coordination issues that barely affect daily life, while others require comprehensive support for all activities.

Brain injuries during birth often result from hypoxic-ischemic encephalopathy, which we’ll discuss in detail next, but can also occur from physical trauma, bleeding in the brain, or stroke during the birth process.

The lifetime cost of care for a child with cerebral palsy can exceed $1.6 million when accounting for medical care, therapy, assistive devices, educational support, and lost economic productivity. Beyond the financial impact, families face emotional, physical, and logistical challenges that reshape their entire lives.

Early intervention makes a significant difference in outcomes. Physical therapy, occupational therapy, and speech therapy started in infancy can help children reach their maximum potential for independence and quality of life.

3. Hypoxic-Ischemic Encephalopathy (HIE)

Hypoxic-ischemic encephalopathy represents the most common form of newborn brain injury. The term describes brain damage that occurs when a baby’s brain doesn’t receive enough oxygen (hypoxia) or blood flow (ischemia) during birth.

This oxygen deprivation can happen for various reasons:

Umbilical cord problems like compression, prolapse, or knots
Placental abruption where the placenta separates from the uterine wall prematurely
Uterine rupture
Extremely prolonged labor
Mother’s blood pressure problems
Infection

Babies with HIE may appear limp at birth, have difficulty breathing, experience seizures within the first 24 hours, or show abnormal reflexes and muscle tone. Medical teams use specific scoring systems and brain imaging to assess the severity.

One of the most important treatments is therapeutic hypothermia or “cooling therapy.” When started within six hours of birth, cooling the baby’s body temperature by a few degrees for 72 hours can significantly reduce the severity of brain damage. This treatment has transformed outcomes for many babies with HIE.

The effects of HIE range from complete recovery to severe disabilities including cerebral palsy, intellectual disabilities, epilepsy, and developmental delays. The extent of damage depends on how long the brain went without adequate oxygen and how severe the deprivation was.

4. Skull Fractures and Bleeding Around the Brain

Skull trauma during birth can range from minor fractures that heal on their own to serious bleeding around or inside the brain. The most common type is subdural hemorrhage, which means bleeding in the space between the brain and the membrane covering it.

These injuries typically happen during difficult deliveries, particularly when forceps or vacuum extractors are used to assist the birth. The instruments, while potentially lifesaving when used appropriately, can apply significant pressure to the baby’s head.

Linear skull fractures (simple cracks in the skull bone) are the most common type and usually heal without intervention within a few months. Depressed skull fractures, where a piece of bone presses inward, are less common but may require surgical correction.

Subdural bleeding is more concerning because blood accumulating around the brain can create pressure and damage brain tissue. Symptoms include seizures, excessive sleepiness, poor feeding, vomiting, or a bulging soft spot on the baby’s head.

Many minor cases resolve as the body reabsorbs the blood over weeks to months. More severe bleeding may require surgical drainage and can lead to lasting neurological problems.

5. Broken Collarbones During Delivery

Clavicle fractures are among the most common birth injuries, particularly during vaginal deliveries of larger babies. The collarbone can break when the baby’s shoulders have difficulty passing through the birth canal or during maneuvers to deliver a baby in breech position.

This might sound frightening, but clavicle fractures are generally the most straightforward birth injuries to manage. They cause minimal long-term problems and heal remarkably well in newborns.

You might not even know your baby has a fractured clavicle immediately. Sometimes the only sign is that the baby doesn’t move one arm as much as the other, or cries when that side is touched. Some fractures are only discovered days later when a bump appears on the collarbone as healing bone forms a callus.

Treatment is supportive rather than surgical. Medical providers typically immobilize the arm on the affected side by pinning the sleeve to the shirt or using gentle wrapping techniques. The bone usually heals completely within two to three weeks, and there are rarely any lasting effects.

6. Cephalohematoma (Blood Pooling Under the Scalp)

Cephalohematoma occurs when blood collects between a baby’s skull bone and the skin covering it. This creates a raised, soft bump on the baby’s head that typically appears several hours after birth and grows larger over the first few days.

This injury happens in about 2.5% of vaginal deliveries, making it relatively common. The blood accumulation results from pressure during delivery that ruptures small blood vessels between the skull and the tissue layer covering it. Vacuum-assisted deliveries increase the risk.

The key characteristic of cephalohematoma is that the swelling doesn’t cross the suture lines (the natural separations between skull bones). This distinguishes it from caput succedaneum, which does cross these lines.

Most cephalohematomas require no treatment at all. The body gradually reabsorbs the blood over weeks to months. As this happens, the bump may feel harder as the edges calcify before finally disappearing. In rare cases, large cephalohematomas can contribute to jaundice as the blood breaks down and releases bilirubin.

Very occasionally, large cephalohematomas become infected or cause significant anemia, requiring medical intervention. But for the vast majority of babies, this is simply something that looks concerning but resolves on its own.

7. Caput Succedaneum (Scalp Swelling)

Caput succedaneum refers to swelling in the soft tissues of a baby’s scalp. Unlike cephalohematoma, this swelling is above the skull bones in the skin and soft tissue layers. It results from pressure on the baby’s head during a prolonged labor or passage through the birth canal.

This is one of the most common and least concerning birth injuries. The swelling typically appears as a soft, puffy area on the part of the head that was presenting first during delivery. Unlike cephalohematoma, caput succedaneum crosses suture lines and feels softer and more fluid-filled.

Caput succedaneum is especially common in long labors, first pregnancies, and vacuum-assisted deliveries. The sustained pressure causes fluid to accumulate in the scalp tissue.

The good news is that caput succedaneum almost always resolves on its own within a few days, requiring no treatment. It may look dramatic, but it causes no pain and doesn’t indicate any underlying injury to the skull or brain.

8. Facial Nerve Injuries During Birth

Facial nerve injuries cause temporary or, rarely, permanent weakness or paralysis on one side of a baby’s face. You might notice this when your baby cries because one side of the mouth doesn’t move downward, or one eye doesn’t close completely.

This injury happens when pressure during delivery affects the facial nerve, which runs along the side of the face near the jaw. Forceps delivery increases the risk, but facial nerve injuries can also occur during unassisted vaginal births, particularly if the baby’s face presses against the mother’s pelvic bone for an extended period.

Most facial nerve injuries are neurapraxia, meaning the nerve is bruised but not torn. These injuries typically resolve on their own within a few weeks to months as the nerve heals. During recovery, the asymmetry becomes less noticeable.

Caring for a baby with facial nerve injury requires some special attention. You may need to use lubricating eye drops if the baby cannot fully close the affected eye. Feeding might be slightly more challenging initially, and you may need to support the weak side of the mouth.

Complete recovery occurs in the vast majority of cases. Permanent facial paralysis from birth trauma is rare, affecting fewer than 10% of cases.

9. Other Bone Fractures (Arms, Legs, or Ribs)

Beyond clavicle fractures, babies can occasionally experience breaks in other bones during delivery. The humerus (upper arm bone) and femur (thigh bone) are most commonly affected, though these injuries are much less frequent than collarbone breaks.

These fractures typically occur during complicated deliveries, particularly breech births where the baby’s legs or arms are delivered before the head, or in cases of shoulder dystocia where the medical team must perform specific maneuvers to free the baby.

Larger babies face higher risk, as do babies delivered in unusual positions. Sometimes a fracture occurs even when the medical team does everything correctly because the mechanical forces of birth simply exceed what the bone can withstand.

Treatment depends on the location and severity of the break. Many fractures in newborns can be managed with splinting or gentle casting. The remarkable healing capacity of infant bones means most fractures heal completely within four to six weeks with no lasting effects on bone development or function.

In rare cases, fractures can be a sign of underlying bone fragility disorders, so physicians may conduct additional testing if the fracture seems to have occurred with minimal force.

10. Meconium Aspiration Syndrome

Meconium is the thick, sticky, dark green substance that fills a baby’s intestines before birth. Normally, babies don’t pass meconium until after they’re born. However, when a baby experiences stress in the womb, they may pass meconium into the amniotic fluid before or during delivery.

Meconium aspiration syndrome occurs when a baby inhales this meconium-stained amniotic fluid into the lungs. The meconium can block airways, irritate lung tissue, and cause inflammation that makes breathing difficult.

This condition ranges from mild to severe. Some babies have minimal symptoms and recover quickly, while others develop serious respiratory distress requiring mechanical ventilation and intensive care. Complications can include pneumonia, collapsed lung, persistent pulmonary hypertension, and in severe cases, permanent lung damage.

Risk factors include post-term pregnancy (going past the due date), difficult or prolonged labor, maternal conditions like high blood pressure or diabetes, and chronic oxygen deprivation in the womb.

When meconium is present in the amniotic fluid, the medical team watches the baby carefully after birth. If the baby is vigorous and crying, interventions beyond standard care are usually unnecessary. However, if the baby shows signs of distress, immediate respiratory support and suctioning may be needed.

Most babies with meconium aspiration syndrome recover fully, though more severe cases can result in long-term breathing problems or neurological issues if oxygen deprivation was significant.

Understanding Kernicterus and Severe Jaundice

While not technically a birth injury in the traditional sense, kernicterus deserves mention as a preventable condition that can occur in newborns. Kernicterus is brain damage caused by extremely high levels of bilirubin, the yellow pigment that causes jaundice.

Mild jaundice is extremely common in newborns and usually harmless. However, when bilirubin levels rise too high without treatment, the substance can cross into the brain and cause permanent damage to areas controlling movement, hearing, and development.

Thanks to routine screening of bilirubin levels in all newborns and effective treatments like phototherapy (light therapy) and exchange transfusions, kernicterus has become rare. Fewer than 5% of babies with jaundice develop kernicterus, and most of those cases involve delayed diagnosis or inadequate treatment.

Early symptoms include extreme sleepiness, poor feeding, high-pitched crying, and poor muscle tone. If kernicterus develops, permanent effects can include a form of cerebral palsy, hearing loss, problems with upward eye movement, and dental enamel defects.

The key to prevention is taking newborn jaundice seriously, following up on bilirubin tests as recommended, and promptly treating elevated levels. When caught early, even severe jaundice can be treated effectively without any lasting harm.

Which Babies Are at Highest Risk for Birth Injuries

Certain factors significantly increase the likelihood of birth injuries occurring. Understanding these risk factors doesn’t mean injuries are inevitable, but it helps medical teams prepare and monitor more carefully.

Baby-related risk factors:

Macrosomia, or birth weight over 8 pounds 13 ounces
Prematurity before 37 weeks gestation
Breech or other unusual positions in the womb
Male sex (35% higher risk than females)

Labor and delivery factors:

Prolonged labor lasting many hours, particularly prolonged second stage
Shoulder dystocia where the shoulders become stuck
Need for operative delivery with forceps or vacuum extraction
Very rapid labor and delivery
Need for emergency interventions

Maternal factors:

First pregnancy, particularly first vaginal delivery
Gestational diabetes causing larger babies
Small maternal pelvis relative to baby size
Obesity
Previous difficult deliveries

Hospital and geographic factors:

Delivery in rural hospitals with limited resources
Facilities without immediate access to cesarean section capability
Geographic location in the Northeastern United States

It’s important to remember that risk factors don’t guarantee injuries will occur. Many high-risk deliveries proceed without any harm to the baby. Conversely, some birth injuries happen during seemingly uncomplicated, low-risk births.

How Many Birth Injuries Could Be Prevented

Research suggests that up to 80% of birth injuries are potentially preventable with proper fetal monitoring, timely intervention, and skilled delivery techniques. This statistic carries both hope and frustration for families affected by birth injuries.

Prevention strategies that have reduced birth injury rates include:

Improved fetal monitoring: Continuous electronic fetal monitoring during labor can detect signs that a baby is not tolerating labor well, allowing medical teams to intervene before injury occurs.

Appropriate use of cesarean delivery: While cesarean sections carry their own risks, they prevent many birth injuries when used for the right indications. The increased cesarean rate for high-risk deliveries has contributed to the 27% decline in birth injuries since the early 2000s.

Better training in instrumental delivery: When forceps and vacuum extractors are used by experienced practitioners who understand proper technique and know when to abandon attempts, injury rates decrease.

Recognition and management of shoulder dystocia: Specific maneuvers performed in the correct sequence can often resolve shoulder dystocia quickly, minimizing the risk of brachial plexus injury.

Protocols for post-term pregnancies: Not allowing pregnancies to go too far past the due date reduces risks of meconium aspiration and other complications.

However, even with perfect care, some birth injuries remain unavoidable. The physical process of birth involves significant forces, and sometimes injury occurs despite everyone doing everything right. The unpredictability of childbirth means we cannot eliminate all risk.

When preventable injuries do occur, they often result from failures in communication, delays in recognizing warning signs, inadequate staffing, failure to call for appropriate assistance, or deviations from evidence-based protocols.

What to Watch For After Your Baby Is Born

Most birth injuries become apparent within the first hours or days after delivery. Knowing what to watch for helps ensure prompt evaluation and treatment if a problem develops.

Immediate red flags requiring urgent evaluation:

Difficulty breathing or grunting with breathing
Seizure activity or unusual jerking movements
Extreme floppiness or rigidity
Inability to move an arm or leg
Misshapen skull or large soft spots
Excessive sleepiness or inability to wake for feeding

Signs that may develop over the first days:

Swelling or lumps on the head that appear or grow larger
Facial asymmetry, especially when crying
Difficulty feeding or weak suck
Jaundice that seems severe or develops rapidly
One arm or leg that moves less than the other
Eyes that don’t move together or unusual eye movements

Symptoms that may not appear until weeks or months later:

Delayed achievement of developmental milestones
Persistent preference for one side of the body
Unusual muscle tone (too stiff or too floppy)
Poor head control beyond the expected age
Difficulty with coordination as motor skills develop

If you notice any of these signs, contact your pediatrician immediately. Early intervention can significantly improve outcomes for many conditions. Don’t worry about whether you’re overreacting. Medical professionals would rather evaluate a baby and find nothing wrong than miss an opportunity for early treatment.

Getting the Right Diagnosis and Treatment

When a birth injury is suspected, the diagnostic process typically involves several steps and specialists.

Initial evaluation usually begins with a thorough physical examination by a pediatrician or neonatologist. They assess muscle tone, reflexes, range of motion, alertness, and any visible injuries or abnormalities.

Imaging studies provide crucial information:

X-rays identify fractures
Ultrasound can evaluate bleeding in the brain in young infants
MRI provides detailed images of brain structure and injury
CT scans may be used in urgent situations

Neurological testing helps assess brain function:

EEG (electroencephalogram) detects seizure activity
Nerve conduction studies evaluate brachial plexus injuries
Developmental assessments track whether skills are emerging appropriately

Laboratory tests check for metabolic problems, infections, or other issues that might complicate recovery.

Once a diagnosis is established, treatment varies widely depending on the specific injury. Options range from watchful waiting for conditions that resolve on their own to intensive physical therapy, medications, surgical interventions, and long-term rehabilitation.

A multidisciplinary approach often provides the best outcomes. Your child’s care team might include:

Pediatrician or neonatologist coordinating overall care
Pediatric neurologist for brain and nerve injuries
Orthopedic surgeon for bone and joint issues
Physical therapist to improve movement and strength
Occupational therapist for fine motor skills and daily activities
Speech therapist for feeding issues and later communication
Developmental specialist to monitor milestones

Long-Term Outlook and Living With Birth Injuries

The long-term prognosis depends entirely on the specific injury and its severity. Some birth injuries leave no lasting effects, while others result in lifelong disabilities.

Injuries with typically excellent outcomes:

Clavicle fractures almost always heal completely
Caput succedaneum and cephalohematoma resolve without lasting effects
Mild brachial plexus injuries often recover fully
Most facial nerve injuries resolve within months

Injuries with variable outcomes:

Moderate brachial plexus injuries may cause permanent weakness but retain function
Skull fractures usually heal well but can occasionally affect development
Mild HIE may result in learning difficulties or no lasting effects
Meconium aspiration syndrome outcomes range from complete recovery to chronic lung issues

Injuries typically causing permanent effects:

Severe HIE frequently leads to cerebral palsy and developmental disabilities
Complete brachial plexus tears may cause permanent arm weakness despite surgery
Kernicterus causes irreversible brain damage
Severe cerebral palsy requires lifelong support

For families dealing with permanent disabilities, life changes in profound ways. The focus shifts to maximizing quality of life, maintaining health, ensuring access to therapies and equipment, navigating educational systems, and planning for long-term care.

Financial considerations are significant. Beyond medical costs, families face expenses for adaptive equipment, home modifications, transportation to appointments, and often reduced income when caregiving responsibilities limit work hours. Various programs and resources exist to help, including Medicaid, SSI disability benefits, early intervention services, and charitable organizations.

The emotional journey varies for each family. Some experience grief for the child they expected to have, anger at the circumstances, fear about the future, or isolation from typical family activities. Connecting with other families facing similar challenges through support groups and online communities can provide validation and practical advice.

Moving Forward With Knowledge and Support

Birth injuries represent one of the most difficult experiences a family can face. The immediate shock of learning your baby has been injured, combined with uncertainty about the future, creates overwhelming stress during what should be a joyful time.

Understanding the most common birth injuries, their causes, and potential outcomes provides a foundation for navigating this challenge. Knowledge helps you ask informed questions, recognize when follow-up care is needed, and understand the reasoning behind treatment recommendations.

Remember that each child’s situation is unique. Statistics and general information provide context, but your child is an individual who may exceed expectations or face unexpected challenges. The human body’s capacity for healing and adaptation, especially in infancy, can be remarkable.

If you’re dealing with a birth injury diagnosis, reach out for support. Connect with medical specialists who have experience with your child’s specific condition. Seek out physical, occupational, and other therapists who can help your child develop skills. Find communities of families who understand your experience. And take care of your own mental health through this demanding time.

The 27% decline in birth injury rates over the past two decades shows that progress is possible. Continued improvements in obstetric care, fetal monitoring, and neonatal treatment will hopefully reduce these injuries even further. But for families affected today, the focus is on the individual child in front of them and ensuring they receive everything they need to thrive.

10 Most Common Birth Injuries in 2025