Answered by the Cook & Tolley, LLP team · September 3, 2026

How do I know whether my child’s birth injury was caused by medical negligence?

Most situations come down to two questions: (1) Was the care below the accepted medical standard? and (2) Did that lapse actually cause the injury? A bad outcome by itself is not proof of negligence, because some birth injuries can occur even with appropriate care. What tends to raise concern is a time-sensitive problem during labor, delivery, or newborn transition that was not recognized, not escalated, or not treated promptly—followed by harm that medical experts can connect to that lapse.

The most reliable way to confirm (or rule out) negligence is a full review of the prenatal, labor and delivery, anesthesia, and NICU/newborn records by qualified clinicians who can compare what happened to what should have happened.

Common red flags in labor and delivery records

Red flags usually show up in the sequence of events and the charting. It is often less about one isolated note and more about whether the team responded appropriately as risk increased.

• Fetal monitoring concerns without timely action: Non-reassuring patterns (for example, recurrent late decelerations or prolonged decelerations) without appropriate intrauterine resuscitation steps and escalation.
• Delay in moving to operative delivery: A long gap between recognition of worsening fetal status (or stalled labor with distress) and a C-section or other appropriate delivery method.
• Improper use of vacuum or forceps: Use despite contraindications, excessive attempts, poor technique, or continuing an assisted delivery when it is not progressing safely.
• Shoulder dystocia management concerns: Documentation suggesting excessive traction or a disorganized response, which can be relevant in brachial plexus injuries.
• Medication or dosing problems: Oxytocin (Pitocin) or other medications contributing to overly frequent contractions (tachysystole) without appropriate response, or anesthesia issues affecting maternal blood pressure and fetal oxygenation.
• Missed or undertreated maternal complications: Preeclampsia/HELLP, infection (chorioamnionitis), placental abruption, uterine rupture risk (including VBAC contexts), or significant bleeding.
• Neonatal resuscitation delays: Trouble transitioning at birth with delayed airway support, delayed NICU involvement, or delayed treatment of low blood sugar, infection, or jaundice when indicated.

These issues do not automatically mean negligence. They are signals that the decision-making, timing, and documentation deserve expert review.

Write your timeline as a letter to your lawyer (a practical way to get clarity)

If you are unsure what happened, a useful first step is to write the timeline as a letter to your lawyer. The goal is to capture what you personally observed and what you were told, in order, without guessing at medical causes.

Start your letter like this:

• Who: Your name, your child’s name, and where the care occurred (clinic/hospital) and approximate dates.
• Before labor: Key prenatal issues you remember (high blood pressure, diabetes, infections, reduced fetal movement, growth concerns), and what your providers said about them.
• When you arrived: Time you arrived, why you came in, and what you were told about mom and baby at that point.
• During labor: Any changes you noticed (pain, fever, bleeding), what alarms or monitoring concerns staff mentioned, when you were told the baby was “in distress” (if you were), and what actions were taken (position changes, oxygen, IV fluids, stopping Pitocin, calling a doctor, etc.).
• Decision points: When C-section or assisted delivery was first discussed, what reasons you were given, and how long it took before delivery happened.
• Delivery details you were told: Whether vacuum/forceps were used, whether there was a shoulder dystocia, and anything said about the cord, placenta, or bleeding.
• Immediately after birth: Apgar scores if you were told them, whether your baby cried/breathed right away, whether resuscitation was performed, and when NICU was involved.
• After birth and diagnoses: Seizures, cooling therapy, HIE, fractures/bleeding, brachial plexus injury, infection, jaundice, low blood sugar, and when you first learned about each issue.
• Documents you have: Discharge papers, NICU summaries, imaging reports, follow-up neurology/developmental notes, and any messages or portal notes.

Tip: If you do not know an exact time, write “approximately” and anchor it to something you do remember (shift change, a meal, a specific conversation). Avoid filling gaps with assumptions—let the medical records supply the exact timestamps.

Once your timeline is written, the next step is usually to obtain the complete chart (prenatal records, fetal monitoring strips, labor and delivery notes, anesthesia record, medication administration record, operative report if any, neonatal resuscitation record, NICU chart, labs including cord gases if taken, and imaging). That record set is what medical experts typically need to evaluate standard of care and causation.

Next step: Birth Injuries