Perineal Tear

Perineal Tear is a common occurrence in childbirth. 90% of women suffer perineal injury to some degree during vaginal labour.

The intensity of the tear can range from mild to severe. 3rd degree tears and 4th degree tears are the most severe degree of perineal tear. Regardless of the degree of tear, immediate treatment is important to enable recovery.

Risks of Perineal tear

Unfortunately, it is not always possible to predict or prevent these types of tears. Certain factors increase the risk of perineal tear such as:

Shoulder Dystocia
Prolonged 2nd stage of labour
Induced Labour
Epidural Anaesthesia
Instrumental Delivery

Medical Negligence and Perineal Tear

Once delivery is complete, the extent of perineal tear is examined. The degree of tear determines the course for repair. Problems arise when the tear is not classified correctly and treated as a lesser tear. Where tears are not treated at the start, they can lead to livelong problems.

In a previous case, a lady suffered life altering injuries following childbirth. This included urinary incontinence, post-void dribble, bowel urgency and faecal leakage. For several years, she believed her symptoms were an unfortunate consequence of vaginal delivery. After some time, she discovered she had in fact suffered a third degree tear during forceps assisted delivery. The tear was not identified at the time and never healed to any degree. Several surgeries took place to correct the problems caused by the delay in treating the tear. She brought a successful claim for medical negligence following this.

Symptoms of Perineal Tear

Severe tearing can affect many aspects of a woman’s life including her physical and mental health, as well as future pregnancies. In the short term, severe perineal tears make it difficult to look after a newborn. Longer term symptoms can include urgency, incontinence and many women feel they cannot go through a vaginal birth again.

Causes of Perineal Tear

Shoulder Dystocia : This happens the baby’s head is born but the shoulder gets stuck behind the pubic bone of the mother. It is a medical emergency and requires medical intervention. This may include episiotomy, forceps or vacuum delivery. Shoulder dystocia increases the risk of 3rd degree tears and 4th degree tears.

Epidural Anaesthesia: Many woman are unaware that epidural increases the risk of perineal tear and assisted delivery.

Instrumental Delivery: During delivery, if forceps are used, the risks of anal sphincter tear increases.

Types of Perineal Injury

Categories of perineal tears are as follows:

First degree– The skin near the opening of the vagina tears and heals within a week or two.

Second degree– This involves the tear of the vaginal tissue, the perineal muscles. To cure this, stitches may be required and it takes about a month to heal.

Third degree: 3rd Degree tears involve damage to vaginal tissue, perineal muscles and the anal muscles. It needs stitches and careful review to ensure correct healing.

Fourth degree: 4th Degree tears are the most severe form of perineal tear. This includes tears of perineal muscles, anal sphincter and the lining of the rectum. Fourth degree tears need surgery to heal.

Proving Your Perineal Injury Claim

If your labour or after care was badly handled resulting in injury, you may be able to bring a legal claim for medical negligence. If you have questions as to whether your labour and delivery were properly handled, speak with us in confidence. You will deal with only one female solicitor during your case wherever possible.

You can speak with Melanie Power direct on 061-513055 or email our medical negligence solicitors on [email protected].

Birth Injury Solicitors

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