One question the parents can have when their child has suffered a brain injury at birth is how did the injury happen? In the context of a HIE, or hypoxic ischemic encephalopathy diagnosis, this is an important question, especially from a medical legal standpoint. Taking the question, a bit further, today’s educational article and supporting video will tackle this question from a prevention angle, hence the article focus, preventing HIE during delivery.


When parents request an investigation into their baby’s injury, it is here that they can sometimes discover that the reason for the injury was due to a failure on the part of either a doctor or nurse, with the hospital playing a role. Today we are going to focus on not only the diagnosis of HIE, but how it can sometimes be prevented during delivery.




When discussing preventing HIE during delivery, it is important to understand the medical condition HIE. As I stated above HIE is short for hypoxic ischemic encephalopathy. In the context of this article HIE revolves around a reduced level of blood and oxygen which leads to a brain injury. There can be multiple causes of a reduced level of blood and oxygen during delivery. For example, any compression of the umbilical cord can lead to a baby having a decreased level of blood and oxygen.


Umbilical cord compression can be the result of certain medical conditions. For example in a shoulder dystocia situation (shoulder dystocia is when the baby is trapped behind the pelvis and is not freed), as the baby is forced down the birth canal the umbilical cord can sometimes get compressed against the baby and the birth canal wall. Another condition which can lead to umbilical cord compression is a prolapsed umbilical cord. This occurs when the umbilical cord is delivered before the baby. The baby’s head can compress against the umbilical cord, leading to a reduced level of blood and oxygen. These are some of the ways in which a baby’s umbilical cord can become compressed.




When a baby has no developmental issues or genetic issues and is born with a brain injury, parents can really be confused. Especially when mom had an uneventful pregnancy. By uneventful pregnancy I mean there were no problems for mother during pregnancy.


The electronic fetal heart monitor is something that doctors and nurses can use to evaluate how well a baby is tolerating a vaginal delivery. Many hospitals all throughout the United States now use a form of the electronic fetal heart monitor to help determine fetal well-being. The monitor provides information such as the baby’s heart rate, acceleration or deceleration patterns, variability, and other things. A baby that is in fetal distress, or no longer tolerating a vaginal delivery, can be this way in some instances because of a reduced level of blood and oxygen. Certain readings on the monitor will alert doctors and nurses when a baby is no longer tolerating a vaginal delivery.


A baby can run into problems when doctors and nurses fail to diagnose fetal distress. Although a baby has mechanisms in place to deal with the stress of labor and delivery, a baby cannot go on forever in fetal distress. At some point the baby’s fetal reserves will become depleted. Once this occurs, the baby it’s at serious risk developing a brain injury. Remember what I stated above bad a reduced level of blood and oxygen can lead to a brain injury. One of the causes of fetal distress is a reduced level of blood and oxygen.


Doctors and nurses must be ready to abandon conservative treatments for fetal distress if the distress is not corrected through those conservative treatments. In some cases, the only way to help the baby will be to move to an emergency C-section when warranted.




One of the first areas of investigation when a baby has a brain injury at birth it’s going to be the readings from the electronic fetal heart monitor. These readings can help give a view of what was happening with the baby during labor and delivery. When an otherwise healthy baby is born with a brain injury, it is understandable that families will want answers. The readings from the electronic fetal heart monitor can sometimes help provide those answers.


just speak with me further about an investigation into your baby’s brain injury this is what I invite you to do. Pick up the phone and give me a call. You can reach me at 301-850-4832. I talk with families all the time regarding these issues and I would be happy to learn more about your story.


Marcus B. Boston, Esq.

Boston Law Group, LLC

2 Wisconsin Circle, Suite 700

Chevy Chase, Maryland 20815


1-833-4 BABY HELP

Marcus Boston is a Maryland medical malpractice attorney who helps people navigate the Maryland childbirth injury and medical malpractice process to get money for their injuries caused by the carelessness of doctors and hospitals. BLG handles cases in Prince George’s County, Baltimore City, Montgomery County, Howard County, Anne Arundel County, and all other Maryland Counties.