Understanding Frank Breech Baby Abnormalities

A breech baby presents unique challenges during pregnancy and birth. Typically, by the final weeks of pregnancy, most babies position themselves head-down for a smooth exit. However, in some cases, the baby remains bottom-down, known as a breech presentation. One specific type, a frank breech baby, occurs when the baby’s legs are folded flat against the body, with the feet near the head and the buttocks pointed toward the birth canal.

Causes and Risk Factors

Breech presentations can happen for various reasons. Sometimes less movement in the womb may indicate potential issues. Contributing factors include:

• Premature birth: Babies born before 37 weeks often haven’t turned head-down yet.
• Multiple pregnancies: Carrying twins or more can increase the chance of a breech position.
• Uterine abnormalities: An irregularly shaped uterus or the presence of fibroids may restrict the baby’s movement.
• Amniotic fluid levels: Both excessive and insufficient amounts of amniotic fluid can limit the baby’s ability to move into the correct position.

Often, these issues resolve before delivery, but persistent breech positions can lead to complications.

Diagnosing a Breech Position

Breech presentations are typically identified during routine ultrasounds, often around the 28th week of pregnancy. If the baby’s head isn’t positioned low in the pelvis during a physical exam, the doctor may order further imaging to confirm the baby’s position and plan for delivery.

Complications of Breech Births

Complications are more likely when a baby remains in the breech position. For instance, breech births can lead to birth defects such as improper hip development, particularly in frank breech cases where the legs are extended upward. Other potential risks include:

• Cord prolapse: This occurs when the umbilical cord slips through the cervix before the baby, cutting off oxygen supply.
• Birth trauma: The baby’s head may become stuck, increasing the risk of injury during delivery.

Managing Breech Pregnancies

Several options are available to manage a breech pregnancy:

• External Cephalic Version (ECV): Around 36 weeks, doctors may attempt to turn the baby into the head-down position manually. Though often successful, this procedure carries risks such as triggering labor or causing fetal distress.
• Cesarean Delivery: If the baby remains breech, a cesarean section is frequently recommended to avoid the risks associated with vaginal delivery.

Long-Term Considerations

Some breech baby problems later in life stem from complications during delivery. For example, hip development issues may require medical intervention if dysplasia develops. Additionally, children born breech may face a slightly increased risk of neurological or developmental issues, though research is ongoing.

Regular pediatric check-ups can help monitor and address any issues that may arise post-birth.

The Malpractice Perspective in Breech Births

Breech births require careful handling by medical professionals to prevent complications. When there is a failure to diagnose or appropriately manage a breech presentation, the results can be severe, leading to injuries for both the mother and the baby. In these cases, malpractice can come into play.

Common Malpractice Issues in Breech Deliveries

Medical malpractice in breech births can arise from several issues:

• Failure to diagnose breech position: If healthcare providers do not identify the breech presentation in time, it can lead to unplanned and hazardous vaginal deliveries.
• Improper handling of breech birth: Vaginal delivery of a breech baby should only be attempted under specific conditions and with experienced practitioners. Failing to meet these standards can result in serious injuries.
• Delayed decision for cesarean section: Hesitation or delay in opting for a cesarean section can increase the risk of birth trauma, oxygen deprivation, and long-term complications.

Consequences of Malpractice

When malpractice occurs during the delivery of a breech baby, the consequences can be long-lasting. Birth injuries like nerve damage, brain injuries due to lack of oxygen such as hie and cerebral palsy, and severe physical trauma are some of the possible outcomes. These conditions may require extensive medical treatment and long-term care, placing a heavy emotional and financial burden on the family.

Seeking Legal Recourse

For families affected by malpractice during a breech birth, pursuing legal action can provide a way to secure compensation for medical costs, therapy, and ongoing care. Consulting a malpractice lawyer familiar with birth injury cases is essential. One such lawyer is Joseph Lichtenstein, who was awarded malpractice attorney of the year for NY in 2019, 2023, and 2024 and is known for securing substantial verdicts in birth injury cases, including numerous multi-million dollar verdicts.