Answers to Frequently Asked Questions About Birth Injuries

Have questions about what to do if you have been injured in a car or truck wreck in Tennessee or one of the neighboring states? Don’t know how to proceed if a medical error or birth injury has harmed or killed a loved one in Memphis or another Tennessee location? The experienced trial attorneys at the Holton Law Firm have the answers you need. If you do not see your question answered here, contact our office to learn more about your individual case.

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  • What is HIE?

    What is HIE?


    Hypoxic ischemic encephalopathy (HIE) occurs when the brain doesn’t get enough oxygen for a period of time. Neonatal HIE specifically is when the lack of oxygen, or asphyxia, occurs during pregnancy or delivery. While there is treatment available called therapeutic hypothermia, the newborn brain can still experience irreversible damage even with appropriate hypothermia treatment. It has been said that HIE is the single greatest contributor to overall disability.  

    HIE can occur when fetal distress (a low heart rate and/or low oxygen) occurred during or after labor and delivery. This can result in a range of outcomes including children with no health issues, to death or severe and permanent disabilities such as cerebral palsy, epilepsy or developmental delays.  



    HIE, asphyxia, head cooling

    Therapeutic hypothermia is a treatment in which doctors cool a newborn immediately after a traumatic delivery where HIE is suspected. This is done by either doing whole-body or head-cooling directly after birth to prevent further damage to the brain.  


    The therapy involves: 

    • Placing a thermal cap on the baby’s head or placing the baby on a cooling blanket 
    • Reducing the temperature to around 33 degrees Fahrenheit 
    • Monitoring the infant for approximately three days 

    Legal Help is Available  

    There are many instances where a birth injury lawsuit may be appropriate due to a traumatic birth and subsequent brain injury despite cooling treatments. For example: 

    • Failure to treat brain damage with head cooling when it is appropriate
    • Improper administration of head cooling 
    • Delaying of head cooling treatment after a traumatic birth 
    • Missed diagnosis of HIE, causing a failure to treat with head cooling

    Because medical personnel must meet a standard of care when delivering a child, failing to meet that standard of care that results in injury can lead to a birth injury lawsuit. 


    If you suspect a medical mistake during labor and delivery created the need for cooling treatment, or your baby was injured as a result of cooling, it’s important you seek help from a trusted birth injury attorney. The legal team at Holton Law Firm is ready to advocate for you and your baby, and we invite you to review our free guide, Answers to Parents’ Questions About Birth Injuries 

  • What is Pre-term Labor?

    Preterm labor and preterm birth are defined as active labor and a subsequent birth before 37 weeks gestation. According to the World Health Organization, complications surrounding preterm birth is the leading cause of death of children under 5 years old. More importantly, at least 75% of preterm births can be prevented with cost effective measures (WHO, 2018). 


    Risk Factors 


    There are a number of things that increase your risk of having a premature delivery. Among the risks are: 


    • Having a premature delivery in the past
    • Multiple pregnancy  
    • Getting late prenatal care 
    • Being overweight or underweight
    • High Blood Pressure  
    • Smoking 
    • Drinking Alcohol
    • Drug use  

    Signs of Preterm labor 


    Some signs that you may have preterm labor include: 

    • Contractions  
    • Vaginal Bleeding or Leaking 
    • Pressure in the pelvis  
    • Low dull backache 
    • Period like cramping 
    • Belly cramps  

    One type of complication happens when the mother’s water breaks prematurely. This is known as premature rupture of membranes (PROM) and will not normally cause serious issues for either the woman or child. Preterm premature rupture of membranes (PPROM), however, can present far more serious problems and threaten the health of the unborn child.  


    If you are pregnant and experience these symptoms, it is important that you see your physician right away.  There are a number of things that can be done to try and stop or delay premature delivery so it is crucial that you seek medical attention. 


    If your doctor failed to diagnose and treat the condition leading to your child’s birth injury, you may want to seek legal help.  If you need a medical malpractice lawfirm with decades of experience handling cases involving birth injuries and pregnancy related injuries, contact the Holton Law Firm in Memphis at 888-443-4387 to discuss your case. 

  • What is Instrument Assisted Delivery?

    Why Doctors Need Instruments for Deliveries 


    When a baby becomes lodged in the birth canal and the mother is unable to push any further, the delivery doctor may attempt to pull the baby out. If the doctor cannot use their hands because the baby is still too far up the birth canal, they may decide to use an instrument to help. With a delivery instrument, a doctor can reach the baby, grasp his head, and pull him the rest of the way out. The doctor may use either forceps or a vacuum extractor to aid in the delivery for the following reasons: 

    • The baby is stuck in the birth canal 
    • The baby begins to experience fetal distress, and the heart rate becomes concerning 
    • The mother is instructed not to push as a safety precaution

    Types of Operative Vaginal Delivery 


    Two types of operative vaginal delivery methods include the use of forceps and vacuum-assisted deliveries. In a forceps delivery, a metal tool is used with two curved arms resembling tongs. The doctor uses the forceps by sliding the tool around the child’s head and gently pulling. Although it can be a safe way to assist with a difficult delivery, forceps pose risks to both mother and child, including: 

    • Vaginal tearing 
    • Difficulty for the mother to evacuate her bladder or bowels after birth 
    • Minor facial injuries to the baby including external eye trauma caused by the forceps arms 
    • Skull fracture  
    • Temporary weakness in the facial muscles 
    • Bleeding within the skull 
    • Seizures

    Most babies delivered by forceps will have temporary marks on their faces, which are not a cause for concern. While serious injuries from forceps are rare, they can occur and should be treated immediately. 


    In a vacuum delivery, a vacuum extractor also known as a ventouse, is a small metal or plastic cup that uses suction to help the baby out of the birth canal. Typically, a doctor will apply the suction instrument to the top of the baby’s head and gently pull. Although the vacuum is less likely to cause vaginal tearing, other risks include: 

    • Additional pain in the vagina and perineum after birth 
    • Scalp wounds on the baby such as bruising and cuts 
    • Possible skull fracturing or bleeding as the suction can exert a tremendous amount of pressure on the baby’s skull 
    • Both instruments pose risks of anemia and weakening of pelvic muscles 

    Again, serious injury to the baby is not common, but the risk of injury is higher than with a normal vaginal delivery. Also, whenever a vacuum extraction is considered, a Cesarean section is usually also an option that can be considered and may pose less risk to the baby and/or mother.  


    The Holton Law Firm Understands Birth Injury 

    If your baby was delivered by forceps or vacuum extraction and suffered an injury to his face, eyes, skull, or brain, the experienced Memphis birth injury attorneys at Holton Law are here to help.  We understand the risks of instrument delivery, and if negligence occurred we can explain options for recovery to you. Contact us today by starting a live online chat on our website. 

  • What is a Brachial Plexus Birth Injury (BPBI)?

    What is a BPBI?


    A brachial plexus birth injury (BPBI) is caused by damage to the nerves in the neck during delivery. It can cause lasting effects, such as Klumpke’s palsy or Erb’s palsy both of which are types of neonatal brachial plexus palsies (NBPP). Klumpke’s palsy is caused when there is injury to the lower brachial plexus while Erb’s palsy is injury to the upper brachial plexus. Injuries range from mild to severe, with various symptoms that can be temporary or can go on to cause a lifelong handicap. Some of the symptoms of a brachial plexus injury include: 

    • Full or partial lack of movement in the arm 
    • Numbness or weakness  
    • A weakened grip 

    Some of the lasting effects of Klumpke’s and Erb’s palsy include a weak or paralyzed arm, shoulder and hand. While many cases of NBPP spontaneously recover, some may need therapy in order to gain movement, and an earlier diagnosis improves long term results.  Even with early diagnosis, therapy, and even surgery, some children may have a lifelong injury.   


    Risk Factors for BPBI and a subsequent NBPP 

    • Shoulder dystocia. This occurs during a vaginal delivery when a baby’s shoulders get stuck inside the mother and the baby has to be maneuvered out. (March of Dimes) 
    • Instrumented birth. There is a 9 times greater risk for a brachial injury if a doctor chooses to deliver by forceps.  
    • Fetal Macrosomia. This occurs when the baby is in the 90th percentile or above for weight, which increases the risk that the baby will not fit easily through the mother's pelvis, and may require extra force to deliver.  
    • Breech delivery. Babies that are delivered feet-first (breech) increases the chance for shoulder dystocia.  
    • Maternal height. Mothers who have a short stature have an increased likelihood of encountering shoulder dystocia, with the increased risk correlating to the degree of short stature. The level of risk increases as the mother's height decreases. 
    • Excessive Weight Gain During pregnancy. Mothers who have excessive weight gain during pregnancy have an increased risk of shoulder dystocia.
    • Older age at delivery. The increasing age of a mother has been shown to be directly related to complications arising from factors such as prolonged labor and shoulder dystocia (Yarfi et al, 2019).  



    While a BPBI in an infant may resolve on its own, there also may be lasting effects that require further care. Occupational therapy and physical therapy may be needed, while some infants require surgery along with therapy. Some infants do not fully recover despite all efforts to treat the brachial plexus injury.  This could be a costly mistake that could result in a lifelong handicap.  


    Your Baby Deserves Quality Representation 


    If your baby suffered injuries during delivery, you should speak with an attorney. The legal team at The Holton Law Firm can review your case, help determine if you have a birth injury case, and provide superior representation, if necessary. To get started on your case, contact a team member today.

  • What is a VBAC?

    What is a VBAC? 


    VBAC stands for vaginal birth after caesarean. In a VBAC, the mother had a cesarean section delivery and then in a later pregnancy attempts to deliver vaginally. A VBAC can be done safely, but it is important that the nurses and doctors be very vigilant. There are many risks associated with a VBAC, including but not limited to uterine rupture and bleeding risks. A successful VBAC however, is associated with decreased risk of maternal morbidity and future complications in future pregnancies (Asgarian et al, 2019).  

    Why Consider a VBAC? 

    Given the risks, why do some women consider having a VBAC? There are several reasons, including the following: 


    An emotional investment in a vaginal birth. Some women desperately want a natural birth experience and, if their first delivery was a C-section, they want to at least try for a vaginal birth the next time. 

    Quicker recovery. A vaginal birth with no complications means a shorter hospital stay and a faster return to normal activities, something that is particularly appealing to women who already have a child at home.

    Avoids surgery. All surgeries carry risks and the desire to avoid these risks leads many women to attempt a VBAC. If their first C-section was difficult, they might also wish to avoid a repeat of a traumatic experience. 

    Considering more children. The more C-sections you have, the more damage you do to your uterus and the risk of bowel injury and placenta problems is increased. If a woman is planning to have several more children, she may want to avoid these risks by having a VBAC.  


    Factors Contributing to a Successful VBAC 

    There are some factors that are related to having a successful VBAC, these include: 


    Maternal age less than 40 years. It has been shown in some studies that most women with successful VBAC attempts are less than 40 years.  

    Newborn weight less than 9 pounds. This is not always an indication for successful VBAC, but it has been shown that larger infant size have a higher uterine rupture rate.  

    At least two years since a prior delivery. It has been shown that the optimum time between inter-delivery births is 2-4 years.  

    Normal BMI. There is a higher risk of complications such as postpartum hemorrhage in women with higher BMI rates. 

    One or two prior c-sections. You are likely not a candidate for VBAC if you have had multiple c-sections, or if you have had a high vertical uterine incision. 

    Spontaneous labor. Inducing labor during a VBAC may increase the chance of labor ending in a C-section. Medicine used to induce labor can increase the risk of a uterine rupture.  


    Risk Factors involved with a VBAC 

    While a large percent of VBAC attempts are successful, there are still many risks involved:  


    Failed labor. The most common complication experienced during an attempted VBAC is failed labor. When this happens, women face a C-section after a long and difficult labor, which makes the surgery riskier than a scheduled C-section would be. This happens in roughly 20–40 percent of all VBAC attempts. 

    Uterine rupture. The most concerning risk is that of uterine rupture, a very dangerous and possibly fatal complication of a VBAC, which could lead to uncontrolled bleeding, infection, hysterectomy, and brain damage to the baby. A tear in the uterus can occur along a previous C-section incision scar. 

    Bleeding risks. Even in cases where the uterus does not actually rupture, the incision site from the C-section could bleed, causing the mother to experience dangerous blood loss and require transfusions. 

    OASIS. Higher risk of obstetric anal sphincter injuries (OASIS), which are also known as 3rd and 4th degree tears. Having a prior emergency c-section doubles the risk of an anal sphincter injury.  



    Ultimately it is a decision to be made between the health care provider and the patient. According to a recent study, “The success rate of VBAC as a safe and feasible method of delivery after a CS is high, especially when the inter-delivery interval ranges from 2 to 4 years” (Asgarian et al, 2019). 


    If you suffer complications due to a VBAC, you may have a case against the doctor, medical team, or hospital. Call our attorneys now to discuss your case in a free consultation. 

  • What is the difference between a birth injury and a birth defect?

    Of the nearly four million babies born in the United States each year, approximately 150,000 are diagnosed with a birth injury or birth defect, according to statistics from the Physicians Committee for Responsible Medicine. When parents learn that their newborn has been diagnosed with a birth injury or defect, it's important that they understand the differences between these diagnoses. Difference between birth defects and birth injuries

    Birth defects are physical or biochemical abnormalities that occur during the infant's development. These abnormalities can be caused by genetics or other factors such as the use of illicit drugs, alcohol, or certain prescription medications during pregnancy, and they may result in lifelong physical or mental disabilities. Common birth defects include:

    • Congenital heart disease
    • Down syndrome
    • Cleft lip and palate
    • Spina bifida
    • Club foot

    Birth injuries are injuries and traumas sustained by otherwise healthy infants during the labor and delivery process, often as the result of a doctor or nurse's mistake. Birth injuries are particularly common in cases involving prolonged labor, delayed delivery, or instrument-assisted delivery. Common birth injuries caused by medical negligence include:

    • Brain injuries such as Cerebral palsy
    • Brachial plexus injuries such as Erb's palsy and Klumpke's palsy
    • Broken bones such as clavicle fractures
    • Cephalohematoma (bleeding underneath the cranium)
    • Caput succedaneum (severe swelling of the scalp tissue)

    The biggest difference between birth defects and birth injuries is that birth defects aren’t normally linked to a medical mishap and are not usually legally actionable. Exceptions may include cases where a birth defect is thought to have been caused by the use of a prescription drug linked to an increased risk of birth defects.

    Experienced Representation for Birth Injury Plaintiffs

    If your infant was diagnosed with a birth injury that you believe was caused by a mistake made by a doctor, nurse, or other medical professional during the labor and delivery process, you may be entitled to seek compensation. The knowledgeable birth injury attorneys with Holton Law Firm can help you explore your legal options. Contact Holton Law Firm today to schedule an appointment for a free initial case analysis.


  • What steps should I take after a cerebral palsy diagnosis?

    Finding out your child has a disability that requires life-long care can be traumatic and frightening for parents. Understanding the disability, the challenges it presents, and the legal options available to you can help you decide what to do after a cerebral palsy diagnosis. After a cerebral palsy diagnosis

    What Is Cerebral Palsy?

    Cerebral palsy is a serious central nervous system disability that can have wide-ranging, adverse effects on a child and will often impact movement and posture, as well as cognitive development. This disease and its treatments can be incredibly costly, as people with this disability often require a number of supportive care services, including special medical care, tailored education and social services, and the use of assistive devices such as braces, walkers, and wheelchairs.

    Over a lifetime, these necessary services cost an average of $921,000 per person, according to a Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR), published in 2003.

    Caring for someone with cerebral palsy can be extremely expensive. However, if your child's cerebral palsy was caused by oxygen deprivation during the birth process, you may be eligible to seek compensation for medical malpractice related to a birth injury.

    After a Cerebral Palsy Diagnosis

    When you're faced with a cerebral palsy diagnosis, take the following steps to help ensure your child is able to receive the appropriate care:

    • Find the right pediatrician. Look for a doctor who has experience treating children with cerebral palsy and can develop a treatment plan that meets your needs, as well as address any concerns you may have.
    • Hire an attorney. A knowledgeable personal injury attorney can help you pursue compensation for your child's birth injury and work to ensure you receive a fair settlement offer.

    Do You Need a Personal Injury Attorney?

    If you're considering taking legal action in a birth injury case, the skilled personal injury attorneys with the Holton Law Firm can provide the honest, yet aggressive, representation you need. Contact our Memphis law office today to schedule a free initial consultation about your case. You can also request a free copy of our eBook, Answers to Parents' Questions About Birth Injuries, for more information.


  • Can a doctor’s mistake cause both birth defects and birth injuries?

    Birth-related medical malpractice happens when a medical professional or a hospital fails to use reasonable care during a woman’s pregnancy and the labor and delivery of her child. When anyone on the medical staff acts negligently, it can cause a birth defect and/or a birth injury that may affect a child for the rest of his life. 

    Birth Defects and Medical Negligence

    Every 4.5 seconds, a baby with a birth defect is born in the U.S., according to the Centers for Disease Control and Prevention (CDC). A birth defect is a structural change that occurs at birth and can impact almost any part of a baby’s body. This change may affect how the body part looks, functions, or both. It can last a lifetime or even end in death.

    One common birth defect is cerebral palsy, and a child with this condition will typically have difficulty controlling muscle motion. A newborn may suffer from cerebral palsy for a variety of reasons, including not getting enough oxygen flow to the brain (referred to as hypoxia) or enough oxygen to the body (referred to as asphyxia). Umbilical cord problems and excessive hemorrhaging during pregnancy or delivery can also cause cerebral palsy. Often, a doctor’s mistake or series of mistakes is the cause of a birth defect that could have been prevented.  

    Birth Injuries and Medical Negligence

    Birth injuries can also be caused by medical negligence. These injuries include:

    Some of these may result from an unavoidable complication, but most occur because a doctor:

    • Uses excessive force to pull or rotate the baby
    • Uses extraction tools improperly such as forceps or a vacuum
    • Fails to monitor the vital signs of the fetus or mother, or both
    • Fails to give a cesarean section when necessary
    • Gives the wrong dose or wrong medication

    A Team Committed to Your Case

    If you believe a doctor, nurse, or other medical staff member injured your baby or is responsible for a birth defect, it’s important to contact an experienced attorney. At the Holton Law Firm, we want to put our combined years of experience to work for you. To begin a conversation with a member of our team, contact us today.


  • What is Klumpke’s palsy?

    A doctor must meet an expected standard of care each time he cares for a patient, which includes making good decisions during a complex birth. If the doctor who delivered your child used excessive force or pulled the baby from the birth canal by an arm extended above the baby’s head, damage to the child’s nerves can result—known as Klumpke’s palsy. It’s important to understand this condition, how you can identify it, and how a lawyer can help determine if you have a birth injury lawsuit.  Klumpke's palsy

    Understanding Klumpke’s Palsy

    Also known as Klumpke’s paralysis or Dejerine-Klumpke palsy, Klumpke’s palsy is a condition resulting from injury to a newborn’s brachial plexus—the network of nerves sending signals from your spine to your hand, arm, and shoulder. This injury occurs when:

    • The nerves are totally severed from the spine
    • The nerves are torn at an area not connected to the spine
    • The nerves are overstretched
    • The nerves were injured but did not heal properly

    This type of birth injury usually occurs during a vaginal delivery, and it could be the result of a doctor’s negligence. Common symptoms of this injury include:

    • Rigid, claw-like hands
    • Asymmetrical posturing
    • Bent arm held close to the body
    • Weak muscle on the affected side
    • Diminished sensation or function in the arm, or total paralysis
    • Excessive pain

    Although not every birth injury is caused by a doctor’s negligence, it’s possible your baby’s Klumpke’s palsy was preventable. A delivery becomes more complicated and difficult if:

    These scenarios may lead a doctor to use more force when helping the baby exit the birth canal and pull too hard or pull on the baby’s arm, which is often extended over the baby’s head. This extra force can lead to injuries resulting in Klumpke’s palsy.

    Effects of Klumpke’s Palsy Could Last a Lifetime

    Determining whether you have a potential birth injury lawsuit is important because the effects of an injury leading to Klumpke’s palsy could last the rest of your child’s life. Many injuries to the brachial plexus will heal with no complications. However, other injuries may lead to long-lasting or permanent consequences—which means your baby could need continued medical attention. Common complications associated with Klumpke’s palsy include:

    • Pain. It’s not uncommon that nerve damage results in pain. This may be connected to how the nerves heal and if any scar tissue exists.
    • Stiffness. Because the pain limits mobility during the healing process, it’s possible joints and muscles will become stiff and difficult to move, or they may even stay rigid after the injury is healed.
    • Permanent disability. The nerves in the brachial plexus could heal improperly, failing to restore connectivity with the brain and losing functionality entirely.
    • Loss of feeling. It’s possible that scar tissue or improper healing will result in loss of feeling in the shoulder, arm, and hands.
    • Atrophy. Nerves can take a while to heal, and it’s important to keep in mind that some nerves must regrow. As this happens, your baby’s muscle might atrophy—which could mean muscle deterioration or prolonged weakness.

    During childbirth, if a baby’s nerves were simply stretched, the injury typically heals more easily. If the baby’s nerves were torn, the injury may be improved by engaging in prescribed physical therapy to keep the joint active and get blood flowing to the area. Additionally, a doctor may recommend surgery to remove scar tissue if he believes the injury isn’t healing as well as it needs to.

    Your Baby Deserves Quality Representation

    If your baby suffered injuries during delivery, you should speak with an attorney. The legal team at The Holton Law Firm can review your case, help determine if you have a birth injury case, and provide superior representation, if necessary. To get started on your case, contact a team member today by calling our toll-free phone number.


  • What is gestational diabetes and What Risks are Involved?

    A 2014 report from the Centers for Disease Control and Prevention (CDC) estimated that gestational diabetes (GD) affects between 1 to 14 percent of births each year in the U.S. If you’re pregnant, it’s important to understand the risks of GD and how it can impact you and your baby.  Gestational diabetes

    Gestational Diabetes Defined

    Gestational diabetes usually occurs with women in late pregnancy who have never had diabetes. It’s often marked by high blood sugar levels and low insulin production, and these changes can affect how a woman’s body processes and uses sugar. Usually, women who experience GD will see their blood sugar return to normal after delivery, but these women are also at a high risk of developing Type II diabetes.

    Risk Factors of Gestational Diabetes

    Any woman can develop GD, but some women may be more susceptible than others. High risk factors include:

    • Having a family history of diabetes
    • Being aged 25 or older
    • Being overweight, specifically with a body mass index (BMI) of 30 or more
    • Having a personal history of polycystic ovary syndrome
    • Having a personal history of gestational diabetes
    • Having a personal history of delivering large babies
    • Taking certain medications such as antipsychotics or beta-blockers
    • Being of non-white genetic heritage

    Complications for the Baby

    It’s very common for women who have GD to deliver babies who are healthy; however, if you don’t manage your condition, it can be problematic for your child. If you have GD, your baby could be at an increased risk of:

    • Excessive birth weight and size. Typically, a baby’s head is the largest presenting body part, but GD can lead to enlarged chest and shoulders, as well as cause excessive birth weight.
    • Pre-term birth. If the mother has high blood sugar, it may increase her risk of delivering early. Babies who are born prematurely may suffer from respiratory distress syndrome. This condition makes it difficult for babies to breathe normally.  
    • Type II diabetes later. Babies whose mothers experienced GD may be more prone to obesity later in life and, therefore, may have a higher risk for developing Type II diabetes.
    • Hypoglycemia. If a baby’s insulin production is high because his mother’s is low, he may experience low blood sugar (hypoglycemia) at birth, which can be normalized through feedings and medications.

    When You Need Legal Help

    If medical professionals failed to test you for GD or failed to manage your case properly, you may be entitled to compensation for your injuries or those to your newborn. To ask questions and learn more about how to proceed with a birth injury lawsuit, call the experienced team at the Holton Law Firm. You can reach us at 888-443-4387.