Can a traumatic birth cause autism? What the research actually says

Many parents worry that complications during birth may increase the risk of conditions such as autism. While the exact causes of autism remain unknown, researchers have examined perinatal and neonatal factors as potential risk factors to understand if there is a link.

This guide provides a clear, evidence-based explanation of what we currently know about the relationship between birth trauma and autism, what perinatal factors may influence risk, and when birth complications might be linked to medical negligence.

What is autism?

Autism, or Autism Spectrum Disorder (ASD), is a lifelong condition affecting many individuals worldwide.

It’s characterised by challenges in social interaction, communication, and repetitive behaviours. Individuals with autism may also have unique strengths and differences in sensory processing.

Can autism be caused by trauma at birth? (The short answer)

Current scientific evidence shows no single traumatic event, including birth trauma, has been proven to directly cause autism.

Autism is widely understood to be a neurodevelopmental difference shaped by genetics, with certain environmental factors sometimes associated with a higher likelihood. While some of these factors include complications around birth, there is no evidence to show that environmental factors are a direct cause. 

Can forceps delivery cause autism?

There is no evidence that forceps delivery directly causes autism. Large-scale studies show that while difficult, assisted, or prolonged births can sometimes be associated with increased risk factors, forceps use itself is not a proven cause.

Forceps-assisted births are often used to protect the baby when complications arise. In those cases, the underlying complication may be associated with increased risk, and not the forceps. 

What are the perinatal and neonatal factors that impact autism?

Researchers have long been interested in understanding the cause of autism, and perinatal and neonatal factors have emerged as possible contributors. Perinatal refers to the period immediately before and after birth, while neonatal pertains to the first 28 days of life. By investigating these factors, researchers hope to shed light on the potential causes of autism.

Perinatal factors associated with autism in research

One study revealed several perinatal and neonatal factors that can be associated with an increased risk of autism. Some of the main factors from this study include:

• Abnormal presentation
• Complications with the umbilical-cord
• Foetal distress
• Birth injuries or trauma
• Multiple births (birth of more than one baby such as twins or triplets)
• Maternal haemorrhages
• Low birth weight
• Premature birth

Neonatal factors linked to autism in research

Another study linked the risk of autism with low Apgar scores within the first 5 minutes of birth. Out of a score of 10, this study found:

• Scores 1-3 had an 88% higher risk of severe forms of autism
• Scores 4-6 were associated with an increased risk, but not as high

It’s important to note that Apgar scores don’t directly cause autism but indicate fetal distress. The study suggests birth complications like oxygen deprivation might increase risk when combined with genetic factors, but are not direct causes.

Some other common neonatal factors found in various studies include:

• Neonatal jaundice
• Respiratory distress or oxygen deprivation
• Neonatal infections
• NICU admission

Perinatal factors not associated with autism in research

The first above study, and another in Canada, found that certain factors were not associated with autism risk, such as:

• Anaesthesia or epidural use
• Assisted vaginal delivery (such as forceps)
• Late birth
• High birth weight
• Head circumference

Based on these findings, can birth trauma cause autism?

While some studies have identified an association between perinatal and neonatal factors and an increased risk of a child developing autism, it is important to note that there is a lack of evidence to suggest there is a single factor that causes autism. The complications associated with an increased risk are not proven to cause autism, and most children who experience perinatal complications do not develop autism.

A combination of factors and environmental exposures during the perinatal and neonatal period may contribute to the risk of developing autism.

When could birth trauma be linked to medical negligence?

Birth complications can sometimes occur despite excellent care. However, there are some situations where errors in monitoring, delayed intervention, or mismanaged labour may cause avoidable harm.

For example:

• Failure to act on foetal distress
• Delayed emergency Caesarean
• Improper use of delivery instruments
• Inadequate monitoring during labour
• Mismanagement of maternal infection or haemorrhage

If avoidable mistakes led to trauma during birth, and your child later received a diagnosis such as autism or developmental delay, you may wish to explore whether negligence contributed to their condition.

When should parents seek legal advice?

You do not need to be certain that medical negligence during birth of your child contributed to an injury. Seeking legal advice can help you understand this. You may benefit from legal support if you:

• Believe mistakes were made during delivery
• Were not properly monitored during pregnancy or labour
• Experienced a traumatic birth that you feel was avoidable
• Want clarity about whether treatment was handled correctly

Fletchers birth injury experts can review your medical records and help establish whether your experience may meet the criteria for medical negligence.

Conclusion

Research has identified that while certain factors indicate an association between birth trauma and autism, the cause of autism is complex. Therefore, it is likely that there is a combination of genetic and environmental factors which contribute to the development of autism.

Research continues to be carried out to further understand the relationship between birth trauma and autism, further improving the understanding of potential risk factors. We can work towards early detection, intervention, and support for individuals with autism, in order to improve their quality of life.

If you have concerns about the care you received during labour or birth, our specialist birth injury solicitors are here to help. Contact us today.

It’s important to note that most babies born after stressful pregnancies do not develop autism. 

That said, some birth complications such as low Apgar scores, oxygen deprivation, or significant neonatal distress have been associated with a higher likelihood of an autism diagnosis later in childhood. This does not mean the birth injury caused autism, only that it may be one of the factors contributing to risk.