Asphyxia and Oxygen Deprivation

Birth complications are rare, but when they occur, events such as asphyxia can be life-changing. Asphyxia is a condition in which the brain receives inadequate levels of oxygen supply. Although it’s now estimated that fewer than 9 percent of cases are linked to asphyxia, oxygen loss is a dangerous and often preventable complication that leads to physical impairment, or even death.

What is Birth Asphyxia?

Asphyxia is a condition in which the body and, most importantly, the brain receives inadequate, or no, oxygen supply. Choking and hyperventilating are everyday examples that cause lack of oxygen to the brain. It was once thought that asphyxia due to complications at birth was the cause of Cerebral Palsy. Now it is estimated that asphyxia accounts for only 6-8% of all Cerebral Palsy cases.

Events that can lead to birth asphyxia include, but are not limited to:

• Umbilical cord problems, such as a prolapsed cord, that can choke the child during delivery
• Excessive hemorrhaging (bleeding) while pregnant or during delivery
• Abnormal presentation where the baby does not enter the birth canal head first during labor
• Prolonged or traumatic delivery due to the baby’s head being too large to fit through the birth canal, known as cephalopelvic disproportion
• Delivery involving shoulder dystocia, a very serious situation where one or both shoulders impede delivery
• Maternal shock, a complication of heavy bleeding and fetal distress which can lead to placenta abruption

The 150-year-old industry debate

Debate exists over how many cases of Cerebral Palsy are caused by asphyxia (oxygen deprivation) occurring during delivery of the newborn. There is also disagreement over the number of cases of asphyxia that could have been prevented.

The debate is documented in the early days of Cerebral Palsy research, nearly 150 years ago, when Dr. William Little suggested the condition was caused by complications during delivery. Later, Sigmund Freud hypothesized the difficult birth was actually a symptom of problems occurring during fetal development. It is now known that asphyxia is one of several possible causes of Cerebral Palsy.

Various studies place the frequency of asphyxia during delivery in a range from 8% to 23%, whereas the American College of Obstetricians and Gynecologists (ACOG) claim the rate is as low as 4%. Those who support the lower range of frequency typically cite American studies while supporters of the higher range typically cite surveys conducted outside the United States.

Some believe those in the medical field draw attention away from a preventable cause of Cerebral Palsy by understating the occurrence of asphyxia during labor and delivery, mainly to protect doctors from medical malpractice lawsuits. Others assume Cerebral Palsy is the result of events occurring prior to delivery, most of which are ruled unknown.

Many doctors – and many medical malpractice lawyers – believe asphyxia plays an important role in brain injuries that occur during labor and delivery. Asphyxia, under these circumstances can be prevented.

Why understanding the cause of asphyxia is important,
and highly controversial

In some cases, asphyxia can be prevented. If a child has Cerebral Palsy due to asphyxia, it is highly advantageous to fully understand circumstances surrounding the cause of the child’s Cerebral Palsy, specifically how the lack of oxygen occurred.

Asphyxia can be caused by a number of scenarios. If asphyxia is related to neglect, medical malpractice, birth injury, or a mistake by clinicians, the law recognizes the undue burden placed upon the child and his or her family. The law provides families with the right to pursue lifetime benefits for the child through litigation. Lifetime benefits may include monetary rewards for the life-long treatment and care the child will require. Although outdated by inflation, it was estimated from 2003 data that a child diagnosed with Cerebral Palsy in 2004 would incur nearly $1 million in related expenses over his or her lifetime. Not every child will qualify for lifetime benefits, but for those who do, lifetime benefits can be life-altering.