Repairing a fourth degree tear
A fourth degree tear should be detected shortly after the delivery during a routine examination. Once diagnosed, a repair should be performed at the earliest opportunity. A patient should be taken to the operating theatre and given the appropriate anaesthetic. If a spinal epidural has been administered, this can be ‘topped-up’.
When a patient has been made comfortable, a surgeon can proceed to suture the injury with dissolvable stitches. This is much more complicated than repairing a first or second degree tear, so it is important the surgeon has the necessary skills and expertise. Under no circumstances should a midwife repair a fourth degree tear.
Follow-up care after a fourth degree tear
After the procedure, medical professionals should provide a patient with:-
- Pain relieving medication
- A course of antibiotics, to prevent infection
- Laxatives, to ease the passing of stools
When the wound is thought to be healing properly, a patient can be discharged from hospital. Medical advice should be given upon wound management. This will include information on maintaining a good level of hygiene, keeping the wound clean, keeping hydrated and doing pelvic floor exercises.
Further treatment for fourth degree tears
If a fourth degree tear does lead to further health complications, more extensive medical treatment may be required. Some of these treatments may lead to a complete recovery, while others are simply to help a woman manage her condition. These include:-
- Physiotherapy to strengthen pelvic floor muscles
- Further surgery to rectify a poor repair, a fistula or an undiagnosed tear
- A colostomy bag for faecal incontinence
- A catheter for urinary incontinence
- Sacral nerve stimulation
Unfortunately even with medical intervention, some women will not go on to make a full recovery. This is because a secondary repair (meaning a repair that is performed after a significant delay) is not as effective as a primary repair (meaning a repair that is carried out soon after the injury).
If medical professionals are to blame for this delay in treatment – for example, because the fourth degree tear was not diagnosed before a patient was discharged from hospital – the level of care will be considered unacceptable. This could lead to a successful compensation claim.
Make A Free Enquiry
If you, or your family member, has suffered a birth injury tear, please call us now for free, no obligation advice on 0800 234 3300 (or from a mobile click to call 01275 334030) or complete our Free Online Enquiry.