Birth injuries, unfortunately, are a fact of life for many. Birth injuries are sometimes caused by a faultless event at birth, and sometimes they are caused by the physician delivering the baby. Some birth injuries are considered minimal, while others cause the death of an infant. One type of birth injury that many people are not familiar with, is the hematoma. There are different types of hematomas, each one basically means that there is an abnormal collection of blood. The different types are determined with which layers of skin are affected, and where the blood is pooled. Hematomas occurring at birth, can be caused by different factors, two of which are the all too common vacuum method of delivery, and physician error. In our case, our son’s hematomas were caused by physician error.
During the delivery of my fourth, and last, child, the physician delivering him tried a special technique during the birth. When I reached a point in my labor where I was almost, but not quite, fully dilated, and had an uncontrollable urge to push, I communicated this to the physician. I was reaching out for help in getting back in control of the pushing, when he suggested to me that he knew a technique for getting the last “lip of the cervix”, as it is commonly called, over the baby’s head so that I could go ahead and push. At the time, I was grateful that the physician was really trying to help me get through this labor and delivery, and was immediately calmed when he said this could be done. When I felt as though I could not keep from pushing, the physician used the technique, and although it was painful, it did mean that my son delivered right then. It quickly became apparent after birth though, that my son had two swollen areas on his head, in the back-top area of his skull.
I asked about these “bumps” repeatedly, but was told repeatedly that the swollen areas would get better before long. Within hours though, they were getting larger, and I was really concerned. Again, we were told that all was well, and that the swelling would go down. It didn’t.
By the next morning, it was also obvious that my son was jaundiced, and was now refusing to nurse. He was almost impossible to wake up, and was not producing wet diapers. I communicated my concern to hospital staff, but they said the jaundice was normal, and that he was just tired from the birth. Now, this was not my first baby, this was my fourth. And I knew something was not right.
I was released from the hospital when my son was just over 24 hours old. Over the next two weeks, the hematomas (which I was told were “subdural hematomas”, but when reading descriptions myself, my son’s hematomas did not fit this description at all. Instead, they fit perfectly the description of a “cephal hematoma”) did not go away. They didn’t shrink at all, and they looked awful. They were not discolored, as some hematomas are. Instead, my son had two “bubble” type lumps on his head. The larger of the two was about the size of half of a baseball, the smaller was about half as big as that. His head was tremendously misshapen, and I found myself glad that he’d been born during the colder months, so that his early pictures could be made a little more appealing by putting little hats on him.
During one of our visits back at the family practice where the delivering physician worked, we ran into him. He stopped us in the hall, as it was the first time he had seen us since my son’s birth. I could see that he was concerned about the hematomas, and even communicated that he was responsible for them. I never was angry with the physician, as he was a very kind and caring individual. I believed he cared for his patients and their babies, and I felt that if he did bear responsibility for my son’s hematomas, that it was entirely accidental, unintended, and that he felt terrible about it. As upsetting as it can be, I understand that birth has the potential to be a dangerous event, and not every birth goes perfectly. I didn’t feel that the physician had made a mistake, I just felt that the technique he used was not without it’s flaws or potential for injury. Had I known that, I would have of course, not allowed him to do it. I feel sure that neither one of us knew this problem would arise. I wish it hadn’t happened, but I am not angry with the physician over it. I know he also wishes it hadn’t happened. That isn’t to say that these hematomas are never caused by physician negligence.
The hematomas resulted in prolonged jaundice, which was also quite stressful. Between hours per day lying in a bouncer seat in the light filtering through the window, to multiple blood tests to check his billirubin levels, to the stress that was caused by not being able to wake him up properly to feed for weeks and weeks, jaundice was a tough experience for us all. The jaundice did not resolve until my son was six months old, at which time the hematomas became nearly totally calcified, and his body was no longer dealing with all of the extra blood that was previously pooled within them.
During these first six months, my son was also quite developmentally delayed, and did not grow well. Even though by the age of five months he was eating quite well, he still only weighed twelve pounds. He did not roll over or sit up until the age of six months, when the jaundice resolved, at which time he quickly caught up, to the great relief of his parents. At the age of two and a half, he weighs nearly 35 pounds, is tall for his age, runs and plays just as normally as any other child his age, and miraculously, is actually quite intellectually advanced. Although there was a time I actually wondered if he wouldn’t be mildly retarded as a result of the birth injury, he certainly proved me wrong. By his second birthday, he had a vocabulary of over 300 words, and speaks now in two and three complete sentences strung together. I am so thankful he his not delayed, as I worried for so long that he would be.
The hematomas never really did go away. They did not always stay “bubbly” and full of blood. In time, they began to calcify, which meant that the “bumps” were now changing into being a permanent part the shape of my son’s head. Although this was occurring, his head was growing also, so the bumps were not quite as noticeable, and his head took on a more normal appearance. It was disheartening that his head was not as normally shaped as I’d hoped, but at this point in time, he can wear a very short haircut and my husband and I are the only ones who still notice that his head is not perfectly shaped, and even we have to actually feel his head to notice.
It is hoped that this article will help other women avoid the delivery technique that could cause this same type of birth injury to their own child.
