Aims and objectives: To identify and analyze the causes of birth asphyxia and birth injuries in viable term neonates. Materials and methods: The neonatal intensive care unit (NICU) admissions of all viable term neonates for birth asphyxia and birth injuries were analyzed between July 1, 2016 and June 30, 2018 in a tertiary care hospital. Those cases where the patient was referred in a state of emergency and was promptly taken up for emergency lower segment cesarian section (LSCS) were excluded. Only those cases, both registered and referred, where a vaginal trial was attempted were considered. The reasons why delivery was not expedited were analyzed to understand if birth asphyxia and birth injuries are preventable in viable term neonates. Results: Birth asphyxia and birth injuries are largely avoidable unless the patient has come in a state of acute emergency and the patient has been promptly taken up for emergency LSCS. The reasons for birth asphyxia and birth injuries in a viable term neonates are—the inability of the attending consultant (i) to decide when the induction of labor has failed, (ii) when not to attempt instrumental delivery and (iii) when to abandon further trial of labor. Conclusion: Birth asphyxia and birth injuries in viable term neonates should ideally never happen. Proper assessment before induction of labor and instrumental delivery is essential and every fetal heart deceleration recorded has to be taken seriously, though every heart deceleration need not be ominous. This will go a long way in preventing NICU admissions and suboptimal outcomes in viable term neonates and the ignominy of having to face litigation.