If your child experienced hypoxic-ischemic encephalopathy (HIE) during birth, it may be time to speak with a birth injury lawyer about filing an HIE lawsuit. While not all instances of HIE are cause for a birth injury claim, medical negligence plays a large role in the prevalence of this heartbreaking injury. Medical malpractice, such as failing to monitor a baby’s fetal heart tracings or mismanaging complications during childbirth, can massively increase the chances of your baby being born with HIE.
This article will discuss the causes, outcomes, and legal implications of HIE. Families who have been affected by HIE, as well as medical professionals and other care providers, should read on to learn more about the nature of the injury, how proper medical care can prevent it, and how qualified HIE lawyers help provide the best possible care to families affected by the devastating injury.
What is Hypoxic-Ischemic Encephalopathy (HIE)?
Hypoxic Ischemic Encephalopathy (HIE) is a form of birth injury involving reduced oxygen and blood flow to the baby’s brain, leading to brain damage. HIE is typically a result of fetal asphyxia (also called perinatal asphyxia) during labor and delivery, when birth complications cause the baby to receive an inadequate supply of oxygen from the mother’s placenta. The injury has many possible risk factors and causes, often overlapping, with various events leading up to the asphyxia. This birth injury is a leading cause of infant mortality and long-term disabilities like cerebral palsy.
To simplify the definition of the injury, we can break down the medical language. The term “hypoxia” refers to a lack of oxygen, and “ischemic” refers to inadequate blood supply. “Encephalopathy” is another word for brain injury, which means that HIE refers to a brain injury that is caused by a restriction of blood flow that deprives organs and tissues of oxygen.
How Common is HIE?
HIE is one of the most common causes of brain injury in newborns, affecting about 1.5 to 2 babies out of every 1,000 live births (according to recent data published by the National Library of Medicine). That means that in the US, between 5,400 and 7,200 babies are diagnosed with HIE every year, and some studies suggest even higher rates. In places with limited medical training and resources, it is much more common, with estimates ranging between 20-30 cases for every 1,000 live births.
Overall, HIE is far too common, especially as an injury that is strongly associated with medical malpractice. HIE is a major global health concern, particularly in regions with limited obstetric care. However, even in the U.S., where advanced medical care is available, thousands of babies are diagnosed with HIE each year—many due to preventable medical errors. In 2025, the injury still accounts for a large portion of infant deaths and lifelong disabilities like cerebral palsy, seizure disorders, and many other impairments.
Causes of HIE Birth Injuries
Hypoxic-ischemic encephalopathy (HIE) occurs when a newborn’s brain is deprived of oxygen and blood flow before, during, or shortly after birth. This lack of oxygen can be caused by many different overlapping medical complications, some of which are unpredictable, while others may be linked to underlying risk factors. While not all cases of HIE can be prevented, proper care during pregnancy can lower risk, and timely medical intervention can minimize the severity of the injury.
Common Causes During Pregnancy
Certain maternal and fetal conditions during pregnancy can increase the likelihood of HIE by affecting oxygen supply, blood flow, or overall fetal health before labor even begins. By being aware of these conditions, doctors can detect early warning signs and plan accordingly, potentially saving your baby’s life.
Common risk factors before birth include:
- Premature birth: Babies born before 37 weeks of gestation have fragile brains, making them far more vulnerable to injuries that lead to HIE.
- Placental insufficiency: When the placenta doesn’t provide enough oxygen or nutrients to the baby.
- Preeclampsia: High blood pressure during pregnancy, potentially affecting blood flow to the placenta.
- Fetal Macrosomia (excessive birth weight): large babies face a higher risk of shoulder dystocia, which can lead to oxygen deprivation during birth.
- Maternal Diabetes: Poorly managed diabetes can lead to macrosomia, increasing the likelihood of complications during childbirth.
- Umbilical cord abnormalities: An umbilical cord that is knotted, compressed, or excessively short can sometimes interfere with the baby’s oxygen supply.
These warning signs increase the likelihood of HIE occurring during childbirth and should be carefully considered by healthcare professionals. Many of these conditions can be monitored and managed with proper prenatal care, successfully reducing the risk of complications during labor. These risk factors are natural, but if doctors do not take every precaution to recognize and manage them, their negligence could result in a HIE lawsuit.
Common Causes During Labor and Delivery
Many cases of HIE are a direct result of complications that arise during labor and delivery. These complications constitute emergencies that restrict the baby’s oxygen supply and should be handled with extreme care. If these issues are mismanaged or unrecognized, they can severely jeopardize the baby’s health by causing HIE.
Common causes of HIE during labor include:
- Umbilical cord complications: A prolapsed cord (when the cord slips through the cervix ahead of the baby), cord compression, or a nuchal cord (when the cord wraps around the baby’s neck) can cut off or reduce oxygen flow.
- Shoulder dystocia: If the baby’s shoulder becomes stuck behind the mother’s pelvic bone, the umbilical cord may be compressed, limiting oxygen flow. Larger babies (macrosomia) are at a higher risk.
- Placental abruption: When the placenta prematurely separates from the uterus, the baby’s oxygen supply is suddenly and severely disrupted, requiring immediate delivery.
- Uterine rupture: A tear in the uterus, often at the site of a previous C-section scar, can interrupt placental blood flow and cause a life-threatening emergency for both mother and baby.
- Prolonged or obstructed labor: If labor lasts too long or the baby becomes stuck in the birth canal, oxygen deprivation can occur.
These complications require immediate medical intervention to prevent lasting harm. When these events cause difficult births and havoc in the delivery room, doctors must think on their feet and act fast to restore oxygen flow and ensure the baby is delivered safely. For example, doctors may need to implement special delivery maneuvers or perform an emergency C-section, weighing their options with extreme care, while considering the context of the complication and any preexisting conditions.
These causes outline the importance of doctors being well-informed about HIE and providing attentive care. Some risk factors can be recognized during pregnancy, giving time for intervention before further complications arise. When medical professionals act with diligence, they can take the necessary steps to inform families and make plans to lower the risks of HIE during childbirth. When they act negligently, they put the well-being of entire families at risk.
Hypoxic-Ischemic Encephalopathy (HIE) Prognosis
The prognosis for babies diagnosed with hypoxic-ischemic encephalopathy (HIE) varies depending on the severity of the brain injury, how quickly treatment is administered, and the overall health of the baby. Some infants recover with little to no long-term effects, while others may experience lasting neurological impairments.
Generally, newborns who experience mild HIE have an exponentially better outlook than moderate to severe cases, with symptoms resolving fairly quickly in many cases. In more serious instances of the injury, the prognosis is generally poor, with 25 to 50% of infants expected to die from the injury, while 25-60% will go on to live with challenging disabilities.
Stages of HIE
HIE is classified into three stages based on the severity of brain dysfunction. These stages help doctors assess the likelihood of recovery or long-term complications. Birth injury lawyers also consider these stages when determining how much compensation to demand in an HIE lawsuit.
- Stage 1 (Mild): Babies with mild HIE may appear slightly irritable or jittery but generally have normal muscle tone and reflexes. Symptoms usually resolve within 24 hours, and most infants recover without permanent brain damage. However, subtle cognitive or developmental issues may still arise later in childhood.
- Stage 2 (Moderate): In moderate HIE, newborns may be lethargic, have weak reflexes, struggle to feed, or experience seizures within the first 24 hours. Therapeutic hypothermia (cooling therapy) is often administered to minimize brain damage. While some babies recover fully, others may develop motor delays, learning disabilities, or mild to moderate cerebral palsy. Close medical monitoring and early intervention can help improve outcomes.
- Stage 3 (Severe): Infants with severe HIE will show minimal response to stimuli, weak or absent reflexes, difficulty breathing, and frequent seizures. Babies in this stage often require intensive medical support, including ventilators and seizure management. The risk of wrongful death or permanent disabilities like cerebral palsy is very high. In the vast majority of severe cases, infants will live with a severe disability or die early in life.
Can a Baby Fully Recover from HIE?
The short answer to this question is yes, babies can fully recover from HIE. However, recovery heavily depends on the severity of the brain injury and how quickly treatment is administered. Expectation management is important, as there are many possible outcomes for babies with HIE, and the success metrics for recovery are relative to each stage of the injury.
Babies with mild HIE usually recover completely and go on to develop normally. Those with moderate HIE may face some developmental delays or motor challenges, but with early intervention—like physical therapy and specialized care—many improve over time. In more severe cases, full recovery is less likely, as significant brain damage can lead to long-term conditions like cerebral palsy or epilepsy.
That said, treatments like cooling therapy and early rehabilitation have helped many babies make remarkable progress. With the right medical care and support, some children with moderate HIE can overcome challenges and lead active, fulfilling lives. Because the quality of medical care is so important for recovery, filing a birth injury lawsuit and seeking maximum compensation is imperative when negligence played a role in the injury.
Outcomes of HIE and Long-Term Consequences
The long-term effects of hypoxic-ischemic encephalopathy (HIE) vary widely and are determined by the severity of brain damage, how quickly treatment is given, and the quality of medical care available to a child throughout their life.
Many HIE survivors experience life-altering birth injuries, resulting in disabilities that require extensive medical treatment, therapy, and assistive care. Many of these complications are characterized by irreversible brain damage as a cause of prolonged oxygen deprivation.
Below are some of the common long-term outcomes of HIE, as well as the challenges families face when living with these complications.
Cerebral Palsy
One of the most well-known and harrowing outcomes of HIE is cerebral palsy, a disorder that affects movement, coordination, and overall mobility. HIE-related cerebral palsy is caused by damage to the brain’s motor control centers, and infants can face lifelong challenges that involve speech delays, feeding difficulties, and severe muscle stiffness. A child with severe cerebral palsy may require wheelchairs, home modifications, specialized education, and around-the-clock care.
Seizure Disorders
Babies who are born with HIE are at high risk of developing epilepsy, a neurological disorder characterized by recurring seizures. Sometimes, victims of HIE will experience a seizure within the first 2 days after birth, and other times the disorders may develop later in childhood. While some cases of epilepsy are mild and manageable with medication, others can be severe and resistant to treatment. These disorders will affect a child’s ability to learn, focus, and function independently. Families will need to move forward with long-term treatment and monitoring.
Cognitive and Developmental Disabilities
HIE can also impact a child’s cognitive function, leading to difficulties with learning, memory, problem-solving, and social interactions. Some children may experience mild delays, while others face severe intellectual disabilities that require special education and full-time support. Common disabilities that develop after an HIE birth injury include:
- Attention deficit hyperactivity disorder (ADHD)
- Autism
- Speech and language delays
- Intellectual disabilities, such as autism.
- Deficits in executive function
Children with attention deficits, autism-like traits, or intellectual disorders may also need ongoing therapy and accommodations in school. Special education, speech therapy, and behavioral therapy are some likely consequences. With these disabilities, quality care and early intervention can make a big difference in improving long-term outcomes.
Other Potential Complications
In addition to motor and cognitive impairments, HIE can cause vision and hearing loss, feeding difficulties due to poor muscle control, and growth delays. Some children develop chronic respiratory problems or struggle with muscle coordination, impacting their ability to perform daily tasks without help. Families should be prepared to provide specialized medical care and long-term therapy.
Overall, these outcomes make quality medical care paramount to living a fulfilling life after HIE. And when these complications arise due to medical negligence, the long-term costs can be staggering. A successful HIE lawsuit can help families secure funds for necessary treatments, medical equipment, and future care, ensuring their child has the best possible quality of life.
HIE Lawsuits and Holding Negligent Parties Accountable
Sadly, many cases of hypoxic-ischemic encephalopathy (HIE) occur because doctors, nurses, or institutions like hospitals, act negligently and fail to provide adequate medical care. In these cases, families have the right to pursue legal action against their healthcare providers. By working with a qualified birth injury lawyer, families can file an HIE lawsuit to secure rightful compensation for medical expenses, long-term care, and other financial and psychological burdens.
These medical malpractice cases can be just as complex as the injury itself, and should not be fought alone. Winning an HIE lawsuit requires strong legal counsel with medical expertise and proven experience with successful birth injury claims.
Medical Malpractice and HIE Birth Injuries
In an HIE lawsuit, the key to proving negligence is demonstrating that a medical provider failed to meet the accepted standard of care, and that this failure led to the baby’s brain injury. Medical professionals are responsible for aspects of care such as monitoring a baby’s health, recognizing warning signs, and taking timely action to prevent or remedy oxygen deprivation. When they fail to do this, the consequences can haunt families forever.
Below are some of the most common medical mistakes that can lead to HIE. These issues often serve as the basis for a birth injury claim:
Failure to Monitor Fetal Distress:
Fetal distress is one of the earliest warning signs that a baby may be experiencing oxygen deprivation. It can be detected through abnormal fetal heart rate patterns, changes in movement, or signs of umbilical cord compression. Medical providers are trained to interpret electronic fetal monitoring (EFM) results and take appropriate action if distress occurs. Failure to properly monitor fetal distress leads to delays in intervention, increasing the risk of brain injury and wrongful death. In some cases, warning signs are ignored, dismissed, or incorrectly labeled as non-emergency, creating legal grounds for a medical malpractice claim.
Delayed C-Section:
In some cases, an emergency C-section is the best course of action when a baby is in distress and at risk of oxygen deprivation. A delayed C-section can have devastating consequences, as prolonged labor complications can cut off oxygen to the baby’s brain and cause other birth trauma. Medical guidelines recommend that doctors follow a “decision-to-incision standard,” which means that once a C-section is deemed necessary, it should be performed as quickly as possible (typically within 30 minutes or less). However, poor hospital coordination, failure to diagnose distress, or hesitation by medical staff can lead to delays. If a doctor failed to order a C-section on time, or if inadequate hospital protocols prevented the procedure from happening fast enough, the family may have a strong case for filing a birth injury claim.
Improper use of delivery tools:
When labor is prolonged or difficult, doctors sometimes use forceps or vacuum extraction to assist in delivering the baby. While these tools can be effective, using too much force (or using them incorrectly) can harm the baby’s head and brain, leading to HIE. This usually happens in the form of:
- Forceps injury: Using excessive force during forceps extraction can cause skull fractures, brain bleeds, or excessive pressure on the baby’s head, leading to oxygen deprivation and HIE.
- Vacuum extraction errors: Misusing a vacuum extractor while delivering a baby can result in excessive suction on the baby’s head, causing hemorrhages, brain swelling, or other injuries that contribute to oxygen deprivation.
Doctors must use these tools with extreme caution and only when medically necessary. If excessive force or improper technique leads to HIE, the medical team can be deemed legally responsible for the resulting injuries.
Pitocin Injuries:
Doctors sometimes administer Pitocin to induce or strengthen contractions, helping mothers deliver during difficult births. While this can be helpful when administered appropriately, improper use can cause excessively strong, frequent, or prolonged contractions. This is called uterine hyperstimulation, which can restrict blood flow to the placenta, causing fetal distress and increasing the risk of an emergency C-section. Doctors and nurses are expected to carefully monitor both mother and baby when administering Pitocin, adjusting the dosage as needed to prevent complications.
What Compensation Can Families Recover?
For families whose child develops serious disabilities due to preventable medical errors, the financial burden can be overwhelming. Outcomes of HIE often involve lifelong medical care, special education services, and assistive equipment. Moreover, these expensive treatments only add to the mental anguish experienced by families who have suffered through a traumatic birth. As a result, families whose baby is born with HIE can be entitled to significant compensation for financial and psychological damages.
A successful HIE birth injury lawsuit can provide financial compensation to help families manage the long-term costs of caring for a child with brain damage, as well as a loss in quality of life. Compensation may cover:
- Medical expenses, such as hospital stays, surgeries, medications, and ongoing therapy.
- Rehabilitation and therapy costs, including physical, occupational, speech, and behavioral therapy.
- Special education services and adaptive learning programs.;
- Medical equipment and assistive devices, like wheelchairs, braces, and communication tools.
- Home modifications for accessibility, such as chair lifts, grab bars, and wheelchair ramps.
- Loss of earning potential for babies whose career prospects are permanently affected.
- Pain and suffering for the emotional and physical toll on the child and family.
The range of monetary compensation in HIE lawsuits varies greatly, as does the injury itself. However, because severe cases of HIE result in lifelong disabilities, these settlements can be substantial. Very serious cases, such as those resulting in cerebral palsy, can command multimillion-dollar settlements for families, as the lifetime cost of care can be extremely expensive.
How an HIE Lawyer Can Help
Experiencing a birth injury like HIE can be incredibly devastating to families, especially when medical negligence may be involved. Teaming up with an HIE lawyer can greatly reduce the emotional and financial toll that families experience in the wake of these events, and victims are encouraged to seek legal help immediately. Moreover, medical malpractice and birth injury cases are vastly complex; they require strong evidence, expert testimony, and strong legal experience. The right birth injury attorney will partner with medical experts to thoroughly investigate your case, gather evidence of negligence, and build a strong claim to secure financial support for your child’s long-term needs.
It is worth it to consider that a birth injury lawsuit isn’t just about compensation, it’s about accountability. Holding negligent parties responsible for their actions can help set legal precedents, leading to improved medical practices and reducing the risk of preventable HIE cases in the future. By taking legal action, you’re not only seeking justice for your own child, but also helping protect other families from experiencing the same preventable harm.
Stalwart Law is Here for Your Family
At Stalwart, we are passionate about fighting for the justice and compensation you deserve. If you suspect that medical negligence contributed to your child’s HIE diagnosis, don’t wait to seek legal guidance. Contact us today for a free consultation. Our team is ready to help you understand your legal options, advocate for your child’s rights, and win your HIE lawsuit to provide the financial security your family needs.
In addition to contacting Stalwart Law about your HIE claim, survivors can reach out to organizations like Hope for HIE for resources and community support.