When a child is diagnosed with cerebral palsy (CP), parents may naturally want to understand what caused the condition and whether something during pregnancy, labor, delivery, or the newborn period played a role. Finding that answer often requires looking beyond the diagnosis itself.
The goal is to determine whether there is evidence of a brain injury, when it occurred, and whether something during the child’s care may have caused it. Doctors and medical experts may review brain imaging, pregnancy and delivery records, fetal monitoring, the newborn’s condition, and other clinical evidence.
Certain findings or events may raise questions about what happened, but they do not by themselves prove that a birth injury or medical malpractice caused the child’s cerebral palsy.
What is the difference between cerebral palsy and a birth injury?
Cerebral palsy describes a group of neurological disorders that affect movement, posture, and balance. A birth injury refers to harm that occurs before, during, or shortly after birth.
The distinction matters because cerebral palsy is a medical condition, while a birth injury describes an event or injury that can cause a child’s condition. An infant can have CP because of abnormal brain development or an injury unrelated to medical negligence. In other cases, a preventable injury around the time of birth may cause or contribute to the brain injury associated with CP.
According to the CDC, CP can result from several different causes, and in many cases, its specific cause is unknown.
What events during birth may justify a closer review?
Certain events and medical findings around the time of birth can raise questions about how a child’s care was handled. They do not necessarily indicate that something went wrong, but they may provide a reason to review the medical records and sequence of events more closely.
Events that may warrant further investigation include:
- A delay in performing an emergency C-section after signs of fetal compromise
- Significant umbilical cord or placental complications
- Extensive newborn resuscitation
- A diagnosis of hypoxic-ischemic encephalopathy (HIE)
- Seizures shortly after birth
- Treatment with therapeutic hypothermia, sometimes called cooling
- Serious maternal or newborn infection
- Severe untreated jaundice
- Evidence of bleeding or injury in the brain
The presence of one or more of these factors does not establish malpractice. Some complications can occur despite appropriate medical care.
A closer review can help establish what happened, when important changes occurred, and whether the available records support a connection between the events surrounding birth and the child’s neurological injury.
Could fetal heart monitoring provide answers?
Fetal heart monitoring can be an important part of a birth injury review because it tracks the baby’s heart rate during labor. The records may help show how the baby’s condition changed over time and when concerns became apparent.
When concerns arise, experts may compare the fetal heart tracing with nursing notes, physician documentation, maternal vital signs, medications, and the timing of delivery.
The important questions often follows the sequence of events:
- When did concerning signs first appear?
- How did they change?
- When did staff recognize them?
- What interventions followed?
- Was an obstetrician notified?
- When was the decision to deliver made?
A fetal heart tracing cannot prove negligence on its own, but it can help reconstruct what information was available to the medical team and when. The surrounding records provide context for how clinicians responded to the changes shown on the tracing.
What can my child’s newborn records reveal?
The hours and days after birth can provide important information about a newborn’s condition and how that condition changed. Newborn records may also help show whether signs of neurological injury were present and what treatment the baby received.
Medical experts may look at:
- Apgar scores
- Umbilical cord blood gases
- Resuscitation records
- Neurological examinations
- Seizure activity
- NICU records
- Blood tests
- Brain imaging
- Infection testing
- Cooling treatment records
However, no single result usually tells the entire story. The records need to be considered together with what happened during pregnancy, labor, and delivery.
For example, the American College of Obsteticians & Gynecologists (ACOG) cautions against using an Apgar score alone to predict an individual child’s neurological outcome. Many factors can affect the score, and most infants with low Apgar scores do not develop cerebral palsy.
Can an MRI show when the brain injury occurred?
Magnetic resonance imaging (MRI) can provide detailed images of the brain and may help physicians identify the location and pattern of an injury. The National Institute of Child Health and Human Development notes that MRI can show brain damage in greater detail than computed tomography (CT).
In a legal investigation, qualified medical experts may consider the MRI alongside the child’s clinical history and other medical evidence to assess whether the findings are consistent with a particular type or timing of injury.
What if my baby was diagnosed with HIE?
An HIE diagnosis may prompt a closer review of the circumstances surrounding a child’s birth, particularly if the child later develops cerebral palsy. HIE can have different causes, so the diagnosis alone does not establish that a birth injury or medical malpractice occurred.
HIE generally involves brain dysfunction associated with inadequate oxygen and blood flow. In a potential malpractice case, the questions may include why the oxygen or blood-flow problem occurred, when it occurred, whether clinicians could reasonably have detected it, and whether appropriate intervention could have prevented or reduced the injury.
What if the hospital says the cerebral palsy was unavoidable?
A hospital may provide an explanation for why a child developed cerebral palsy, but parents who still have questions should seek an independent review of the medical records.
The key issue is whether the medical evidence supports the explanation given and whether there are other factors that should be considered. An independent medical and legal review may examine the records to reconstruct what happened and assess whether a preventable injury may have caused the child’s condition.
Does an emergency C-section mean something went wrong?
Not always. An emergency C-section can be the appropriate response to a dangerous complication, so the procedure itself does not establish that something went wrong. The relevant question is often whether the medical team recognized the need for delivery and responded appropriately.
If fetal or maternal conditions indicated that prompt delivery was medically necessary, experts may examine when those indications developed, when the decision to operate was made, and what occurred before delivery.
What records should parents preserve?
If you have unanswered questions about your child’s birth, keeping the documents already in your possession can be helpful. They may include discharge paperwork, prenatal records, NICU information, imaging reports, test results, and records from your child’s pediatric specialists.
A legal investigation may seek a much broader set of records directly from healthcare providers.
Parents do not need to determine which document proves a case before speaking with an attorney. Birth injury cases often require medical experts to evaluate records together and determine what they show about the child’s care and condition.
How do lawyers investigate whether cerebral palsy resulted from a birth injury?
A detailed investigation begins with reconstructing the medical timeline. Attorneys and medical experts review the records to understand what happened before, during, and after the child’s birth. The goal is to determine whether the medical evidence supports a connection between an injury around the time of birth and the child’s condition, and whether the care provided met the applicable standard.
If you are trying to understand what happened during your child’s delivery, our cerebral palsy lawyers can arrange a confidential doctor/lawyer review of the circumstances and available medical evidence. Contact us today to schedule a confidential consultation.
Clients are not responsible for legal fees or expenses unless a financial recovery is obtained.
