Third and fourth degree tears are types of perineal injury that can be sustained by a woman while giving birth.
Not all women will experience a perineal tear while giving birth. Of those that do, the vast majority (approximately 90%) will sustain either a first or second degree tear. These are relatively minor injuries that involve the perineal skin and muscles.
In terms of a medical definition, a first and second degree tear can be described as:
- First degree tear: laceration of the vaginal epithelium (the tissue lining the vagina) or perineal skin only.
- Second degree tear: laceration of the perineal muscles and fascia as well as the vaginal epithelium and perineal skin.
First and second degree tears are fairly superficial injuries that do not extend to the anal sphincters. They can be repaired in the delivery suite by either a midwife or a registrar. It is unusual to experience long-term problems as a result of a first or second degree tear.
A much smaller number of women (approximately 9%) will sustain a third or fourth degree tear. These are much more serious injuries because they involve the anal sphincter(s). In terms of a medical definition, third and fourth degree tears can be described as:
- Third degree tear: laceration of the vaginal epithelium, perineal skin, perineal body and anal sphincters. Third degree tears can be further subdivided into:
- 3a: partial tear of the external sphincter involving less than 50% thickness;
- 3b: tear of the external sphincter involving more than 50% thickness;
- 3c: external and internal sphincter torn
- Fourth degree tear: the same as a third degree tear, but the injury extends to the tissue underneath (the anal epithelium).
Claiming for 3rd and 4th degree tears
Unfortunately perineal tears are a normal part of childbirth and are not something that can be avoided. Therefore if you sustain a 3rd or 4th degree tear, it does not mean that you have been the victim of medical negligence. As long as it is diagnosed shortly after the birth and adequately repaired, a reasonable standard of care has been provided.
However, if there is a failure to recognise the injury and perform an acceptable repair, the level of care will be substandard. It is very likely that this will cause a patient to suffer unnecessary injury, as an unrepaired 3rd or 4th degree tear normally leads to problems such as faecal urgency and incontinence.
If these problems arise because medical practitioners failed to diagnose and repaired a 3rd or 4th degree tear, there will be grounds for a claim. Contact us today to speak to a solicitor.