A paediatrician asks--why is it called birth injury?

It is irrational to ascribe a child's so called 'brain damage' to labour or delivery without considering other factors. 'Brain damage' occurs without difficult labour or perinatal hypoxia and caesarean section is no guarantee against it. Severe difficulties in delivery and severe hypoxia at birth are in the great majority not followed by evidence of 'brain damage'. In the maternal history there is a significantly greater incidence of relative infertility, and of pregnancies associated with low birthweight or intrauterine growth retardation, postmaturity, antepartum haemorrhage, pre-eclampsia or infections. There are often genetic factors, more congenital anomalies and pathological evidence of underlying abnormality. There is an interaction of numerous factors, prenatal, perinatal and postnatal and it is simplistic to ascribe 'brain damage' to single factors, such as breech delivery or hypoxia at birth, without considering the antecedent causes of those factors.