After an HIE diagnosis, most parents ask the same question: “How did this happen?”
Hypoxic ischemic encephalopathy describes a brain injury, but it does not automatically explain what caused the injury. Understanding causation requires looking closely at what occurred before and during labor and delivery.
WHAT CAUSES HIE IN NEWBORNS?
HIE occurs when a baby’s brain does not receive enough oxygen or blood flow around the time of birth. This can happen in a number of medical situations, particularly during labor and delivery.
Common causes and contributing factors include:
• Placental complications such as abruption, infection, or reduced blood flow
• Umbilical cord problems, including compression or prolapse
• Prolonged or difficult labor with worsening fetal heart rate patterns
• Infection or sepsis affecting the mother or baby
• Obstetrical emergencies such as uterine rupture
• Shoulder dystocia accompanied by a sustained drop in fetal heart rate
These conditions can interfere with oxygen delivery and place stress on the baby’s brain.
IS HIE USUALLY PREVENTABLE?
HIE is not always preventable. Some cases occur despite appropriate medical care. However, other cases involve patterns that raise questions about whether earlier recognition or intervention could have reduced the risk of injury.
Determining preventability depends on timing, response, and the decisions made during labor.
CAN LABOR MANAGEMENT PLAY A ROLE IN HIE?
In some cases, HIE is associated not only with a medical complication, but with how labor was managed. Questions may arise when:
• Signs of fetal distress persist without escalation
• Contractions become excessively frequent or intense
• Pitocin is continued despite concerning monitoring
• There is a delay in moving to a cesarean delivery
Not every difficult labor involves negligence. At the same time, some cases involve missed warning signs or delayed responses.
WHY DO HOSPITALS SAY “THIS JUST HAPPENS”?
Families are often told that HIE is unpredictable or unavoidable. While that may be true in some situations, statements made after birth do not always reflect what the fetal monitor or labor records show.
Understanding what happened requires reviewing the medical records rather than relying on general explanations.
WHAT RECORDS HELP DETERMINE THE CAUSE OF HIE?
A meaningful review of causation often includes:
• Fetal heart monitoring strips
• Nursing and physician notes
• Timing of medications such as Pitocin
• Labor progression and decision points
• Cord blood gas results
A discharge summary alone is rarely sufficient.
WHAT SHOULD PARENTS DO NEXT?
If you are questioning what caused your baby’s HIE, it is reasonable to want answers grounded in the medical record.
A careful review of labor and delivery records can help clarify whether the injury was unavoidable or whether there are unanswered questions about care. You may request a free, confidential case review focused on understanding the medical timeline.
Talk with a birth injury lawyer about what happened here
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