A birth injury refers to any trauma an infant endures during the birthing process. Most birth injuries occur as a result of the infant’s size or position during labor and delivery. For example, the birth canal may be too small, the fetus may be too large, or the fetus may be lying in an abnormal position in the uterus prior to birth. Common injuries as to the infant may include: swelling and bruising of the scalp, cephalohematoma, bone injury (fracture of the clavicle is most common, humerus fracture, femur fracture), intracranial hemorrhage, nerve injury (injury to brachial plexus is most common), perinatal asphyxia, and injury to skin and soft tissues. Markings on the skin, such as bruising, pink marks, may occur as well as a result of forceps use. Long-term conditions, such as brain injury and cerebral palsy, may also arise as a result of birthing injuries. The December 2nd 1999 issue of the New England Journal of Medicine contained a study done by Towner on birth injury due to the various methods of delivery. The study was conducted on 600,000 average weight infants born from 1992-1994 in the state of California. In the study, 66.5% were delivered by spontaneous vaginal delivery, 20.1% by cesarean delivery, 10.2% by vacuum extraction, 2.7% by forceps and 0.5% delivered by both vacuum and forceps. Results from the study with regards to death at birth due to these procedures were as follows: vaginal delivery death rate was 1 per 5000, vacuum extraction delivery death rate was 1 per 3333 and the forceps delivery death rate was 1 per 2000. Intercranial hemorrhages caused by these same procedures were also studied. Statistics were found as follows: 1 per 1900 for vaginal births, 1 per 860 for vacuum delivery, and 1 per 664 forceps delivery. The rate of birth injuries overall is much lower than it has been in previous decades. Improved prenatal assessments that include ultrasonograpy have allowed physicians to determine the best method of delivery for the infant that will produce the least amount of harm. In many cases, cesarean deliveries are done to lessen the chances of trauma to the infant during the birthing process.
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Forensic Nursing Chronicles 
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