Erb's Palsy Awareness Week 16-23 October 2023
As ever, we are pleased to support the Erb's Palsy Group and Erb's Palsy Awareness Week this October. Erb's Palsy is typically the result of an injury sustained at birth following inappropriate treatment following a shoulder dystocia.
The most recent data suggest that shoulder dystocia, where a baby's head is delivered but one of the shoulders is stuck behind the mother's pubic bone, occurs in between 0.15 per cent to 2 per cent of births in the UK. It is an obstetric emergency.
There is however a balance to achieve between ensuring the baby is not deprived of oxygen, which can have catastrophic consequences, and using excessive force or inappropriate methods to release the shoulder, with the risk of causing injury to the brachial plexus, the nerves in the shoulder that carry signals from the spinal cord leading to movement and sensation in the arms and hands.
Unfortunately, a brachial plexus injury is diagnosed in up to 20 per cent of newborns after a shoulder dystocia has been recognised. In other words between 0.03 per cent and 0.4 per cent of births in the UK involve such an injury. With just over 600,000 live births in the UK in 2022, this means that an estimated 180 to 2,400 babies suffer such an injury every year.
Injuries can range from relatively minor and temporary damage to the nerves, with recovery within a matter of days, to instances where the nerves are completely avulsed, leading to catastrophic and lifelong damage.
An important aspect of such injuries is that a significant proportion can be avoided with appropriate care by the midwifery and/or obstetric teams managing the birth. Such care can include recognising when a mother has characteristics that place the baby at risk of an injury, such as a history of shoulder dystocia, maternal diabetes or maternal obesity, or factors that develop during labour, such as a long second stage, or the need for instrumental delivery.
Most notably, however, it also involves ensuring that once a risk is identified, it is dealt with according to established principles, performing certain manoeuvres to minimise the risk of excessive force being applied on the fetal brachial plexus while maximising the chance of a successful delivery.
The team at Fieldfisher has unrivalled expertise in bringing Erb's Palsy claims where maternity and obstetric care is substandard. Last year, we recovered the highest reported settlement in the UK for such a claim.
Hopefully, by continuing to raise awareness of Erb's Palsy and its serious consequences, more will be done to prevent families suffering the trauma that such an injury inevitably brings, and ensuring the NHS, when it is stretched more than ever, can concentrate its resources in improving care for all.