Birth Injury: Hypoxic-Ischemic Encephalopathy (HIE)

There were 3.66 million babies born in the United States in 2021. While many newborns are healthy when delivered, according to the Agency for Healthcare Research and Quality (AHRQ), approximately 0.19% of newborns — 6,954 of infants born each year — suffer birth trauma, which can cause short-term and permanent health issues.

You must speak to a birth injury lawyer if your newborn suffered a birth injury, such as hypoxic-ischemic encephalopathy. A birth injury attorney will explain your rights and legal options for seeking justice for you and your child.

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What are common birth injuries?

The definition of a birth injury is something that occurs during birth that impairs or damages the newborn’s body or bodily functions. There are several types of birth injuries. Some of the most common birth injury types include the following:

  • Brachial plexus injury: Damage to the nerves in the infant’s arms and hands can be temporary or permanent. Bruising and swelling will fade, allowing the newborn to function normally. However, newborns may suffer permanent nerve damage, impairing mobility if the nerves are torn.
  • Broken bones: Birth trauma can cause broken bones. Breech births and shoulder dystocia, which causes brachial plexus injuries, increase the risk of broken bones.
  • Bruising: The use of forceps or vacuum extraction can cause bruising. Newborns may also bruise from pressure when passing through the birth canal.
  • Cephalohematoma: The epicranial aponeurosis is a fibrous tissue that covers the skull. When newborns have bleeding between the epicranial aponeurosis and their skull, they have cephalohematoma. This condition usually takes weeks to months to heal. Prompt treatment is necessary to prevent permanent brain damage or other health complications. 
  • Cerebral palsy: Cerebral palsy refers to brain damage impairing a person’s motor functions
  • Caput succedaneum: Caput succedaneum refers to swollen scalp tissue. The risks of caput succedaneum increase with births involving vacuum extraction.
  • Facial paralysis: Damage to facial nerves can cause facial paralysis. Swollen nerves may heal on their own, but newborns with torn facial nerves may need surgery.
  • Intracranial hemorrhage: Head trauma, blood pressure issues, and aneurysms are some causes of intracranial hemorrhage
  • Spinal cord injuries (SCIs): Some people with SCIs experience short-term health issues that heal with time and treatment, while others suffer permanent impairments affecting a newborn’s mobility for the rest of their life
  • Subconjunctival hemorrhage: Damage to the blood vessels in the newborn’s eyes causes subconjunctival bleeding, which usually heals within weeks

Hypoxic-ischemic encephalopathy is another common type of birth injury.

What is hypoxic-ischemic encephalopathy?

Hypoxic-ischemic encephalopathy (HIE) is brain damage caused by oxygen deprivation. Oxygen deprivation before, during, or after birth can cause hypoxic-ischemic encephalopathy.

Infants with HIE may have multiple symptoms, including the following:

  • Bradycardia
  • Cognitive impairment
  • Extreme lethargy
  • Hearing impairment
  • Hypertonia
  • Hypotonia
  • Lack of appetite
  • Organ failure
  • Respiratory issues
  • Seizures
  • Unusually alert/not sleeping

Medical professionals can use an ultrasound, lumbar puncture, MRI, or blood test to confirm an infant has HIE.

How is hypoxic-ischemic encephalopathy caused?

HIE is a birth injury with several potential causes, including the following:

  • Alcohol or drug abuse: Consuming alcohol or using drugs can affect the mother’s blood pressure, increasing the risk of oxygen deprivation before or during birth
  • Fetal anemia: Low hemoglobin levels increase a fetus’s risk of HIE
  • Heart disease: Heart disease can prevent a newborn from getting enough oxygen to the brain
  • Lung malformations: Issues with lung development can prevent a newborn from getting enough oxygen
  • Maternal diabetes: Diabetes increases the risk of premature birth, which can cause complications such as HIE 
  • Preeclampsia: A mother’s high blood pressure can reduce the amount of oxygen the fetus receives 

There are also things occurring during or after birth that can cause HIE, including the following:

  • Breech birth: Unusual positioning can prevent the newborn from getting enough oxygen
  • Excessive bleeding: Excessive bleeding can reduce the amount of oxygen the newborn gets 
  • Placental abruption: Placental abruption deprives newborns of oxygen and nutrients, increasing their risk of HIE
  • Prolonged labor: An extremely long labor can interfere with the newborn’s oxygen intake
  • Umbilical cord complications: Umbilical cords can wrap around a newborn’s neck and keep them from getting enough oxygen

Premature birth, low blood pressure, respiratory issues, and brain or skull trauma also increase the risk of HIE.

What are the long-term effects of being born with hypoxic-ischemic encephalopathy?

There is no cure for hypoxic-ischemic encephalopathy. A newborn’s symptoms will depend on the severity of their condition and whether they receive a prompt diagnosis and appropriate treatment. HIE can be fatal if left undiagnosed and untreated, which is why it’s crucial medical professionals test for HIE if they note symptoms after the infant’s birth.

Children with HIE are at increased risk of the following complications:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Cerebral palsy
  • Cognitive impairment
  • Developmental disorders
  • Epilepsy
  • Respiratory issues

Why should I consider a birth injury lawsuit?

Newborns with HIE may require expensive medical tests and treatment, such as therapeutic hypothermia treatment. Early intervention gives your newborn the best chance of minimal damage and impairment from HIE.

Medical errors are often the root cause of HIE. These medical errors occur when medical professionals fail to account for potential risks of HIE or intervene to prevent complications, such as performing a c-section. 

A birth injury lawsuit allows you to seek compensation for the financial and emotional costs of HIE. Seeking compensation from a birth injury suit can enable you to secure the funds needed for current and future medical bills so your newborn can get the care they need and deserve.

Should I contact a lawyer for hypoxic-ischemic encephalopathy? 

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Your Colorado birth injury attorney will investigate your child’s birth and explain your legal options. Understanding your legal rights ensures you have the option of pursuing a claim if your child suffered HIE because of a medical error. 

The legal team at Bachus & Schanker includes a Victim’s Advocate team of former legal professionals who explain the legal process. You’ll never feel alone or in the dark; our team is here to answer your questions and let you know what to expect as your case progresses. We provide free consultations and won’t charge any legal fees until we resolve your case. We’ll utilize our skills and experience to build your case and get you the justice you deserve.


High Blood Pressure During Pregnancy. (2023). 

Hypoxic Ischemic Encephalopathy. (2022). 

Maternal and Child Health Care: Person-Centered Care & Patient Safety. (2018).

 Number of births in the United States from 1990 to 2021. (2023).

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Written and Legally Reviewed By: Kyle Bachus

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Kyle is a member of the Colorado and Florida Bar associations and has served on the Board of Directors of the Colorado Trial Lawyers Association for more than twenty years in total. Over the years, Kyle has achieved justice for many clients. He has served on numerous committees and repeatedly won recognition from his peers at both the state and national level. He is proud of the role he has played in the passage of state and national legislation to protect consumers and is a frequent speaker and guest lecturer.