What Are Brachial Plexus Injuries? 2026 Guide for Parents

When parents search for information on brachial plexus birth injuries, it’s often the result of a tense and tearful conversation with their newborn’s doctor. A brachial plexus injury often happens when the nerves that control a baby’s shoulder and arm are damaged during childbirth. Injuries vary widely in severity, with some babies making a full recovery in a matter of weeks and others facing physical limitations for the rest of their lives.

If your baby has been diagnosed with a brachial plexus injury in Ohio, learn more about what these injuries are, how they happen, and what options may be available to your family. Ready to talk about your case in greater detail? Contact Crandall & Pera Law, LLC today.

What is the brachial plexus?

The brachial plexus is a group of nerves that run from the spinal cord in the neck all the way through the shoulder, arm, wrist, and hand. The nerves control shoulder movement, elbow flexion, arm strength, wrist function, hand function, and sensation in the arm and hand.

When nerves are stretched, torn, or compressed during childbirth, a newborn can lose movement or sensation in the affected arm.

How do brachial plexus injuries occur during birth?

Difficult vaginal deliveries can result in a number of birth injuries. While relatively uncommon overall, brachial plexus injuries are among the more frequently reported birth-related nerve injuries. This type of injury commonly follows a birth involving shoulder dystocia.

Shoulder dystocia happens when a baby’s head successfully passes through the birth canal, but the shoulders get stuck behind the pelvic bone. In severe cases, shoulder dystocia can result in oxygen deprivation for the baby. For the mother, it can cause postpartum hemorrhage and severe perineal tearing. In rare cases, other serious complications may occur.

That’s why shoulder dystocia is treated as an emergency. When doctors apply lateral traction to the baby’s head or neck, the brachial plexus can become stretched or torn.

Risk factors for brachial plexus injuries include:

• Macrosomia (more commonly known as high birth weight)
• Maternal diabetes
• Prolonged labor
• Vacuum or forceps delivery
• Breech presentation

Types of brachial plexus injuries

There are several types of injuries that fall into this category, including:

• Neurapraxia: This is the mildest type of brachial plexus injury, although still very frightening for parents and painful for babies. This type of injury involves nerves that are stretched or compressed. Neurapraxia often resolves itself in a matter of weeks or months.
• Neuroma: Neuromas are knots of scar tissue that build up when nerve damage in the brachial plexus does not heal properly. They may develop when nerves are injured, cut, or stretched.
• Rupture: A brachial plexus rupture happens when nerves in this area are torn. This type of injury may require surgery. The affected arm may feel partially or completely paralyzed.
• Avulsion: A brachial plexus avulsion is the most severe type of brachial plexus injury. It occurs when nerve roots completely pull away from the spinal cord. The result is paralysis, severe pain, and complete loss of sensation in the arm. Even with surgical intervention, the affected arm may only regain limited functionality.

What is Erb’s palsy?

It’s also important to discuss Erb’s palsy when discussing brachial plexus injuries, as this is the most well-known injury in this category. It causes weakness, paralysis, and loss of motion in a newborn baby’s arm. Erb’s palsy occurs when the shoulder stretches too much during a difficult delivery. It affects C5 and C6 nerve roots, often resulting in the affected arm dangling by the side, limited shoulder movement, reduced grip strength, and general arm weakness.

Erb’s palsy can refer to various types of brachial plexus injuries, but it does not include all of them, due to the specific nerves affected.

What to expect from brachial plexus injuries

New parents may notice a variety of worrying signs when their little one has a brachial plexus injury, including:

• One arm that doesn’t move
• Weak startle reflex on one side
• Arm held close to the body
• No grip or weak grip in one hand
• Muscle stiffness or unnatural positioning

Early diagnosis is critical. The sooner a newborn is diagnosed, the sooner they can begin physical therapy. Prompt treatment often leads to better outcomes.

Long-term, the outcome of this type of birth injury depends largely on the specific type of injury, how early the baby begins physical therapy and other forms of treatment, and their overall strength. Some babies make a full recovery. Others are left with ongoing challenges, including muscle weakness, limited range of motion, arm-length differences, and motor asymmetry due to asymmetrical movement.

Is it malpractice?

This is a tough question to answer, because it’s not cut-and-dry. In some cases, brachial plexus injuries are not avoidable and occur even though care providers follow the standard of care to the letter. However, other brachial plexus injuries may be preventable, arising from provider neglect.

Potential preventable causes of brachial plexus injuries include:

• Failure to anticipate shoulder dystocia in high-risk pregnancies
• Failure to advise expectant mothers of the risks of shoulder dystocia when the baby is expected to be very large
• Excessive traction during delivery
• Improper use of a vacuum or forceps
• Failure to timely recommend or perform a C-section when medically indicated under the standard of care

Obstetric care providers learn specific techniques and maneuvers to safely treat shoulder dystocia. When providers do not use these techniques appropriately or use unsafe techniques, they put moms and babies in danger.

Whether or not a specific case of a brachial plexus injury is malpractice comes down to the details of the case. Your birth injury attorney will look through your medical records, including labor and delivery notes that highlight when the situation became emergent. To prove medical malpractice, you must be able to show that the provider deviated from the accepted standard of care and that their deviation resulted in your baby’s injury.

We’re here to help during this difficult time—call us today

At Crandall & Pera Law, LLC, we understand the stress and anxiety that come with a birth injury. If your little one has suffered a brachial plexus injury, let’s discuss your case and legal options. Contact us online today to schedule a free consultation.