3rd degree tears can affect any woman giving birth vaginally, but are more common amongst those who have an assisted delivery – such as a forceps delivery.
A forceps delivery is when forceps are placed around the baby’s head and pulled out of the mother’s vagina. This might be required if the birth needs to be expedited (because either the mother or baby is showing signs of distress), or because the birth is not progressing properly (for example, because the baby’s shoulders have become stuck behind the mother’s pubic bone).
To make enough room for the forceps to be inserted into the vagina and applied to the baby’s head, medical practitioners will normally need to perform an episiotomy. An episiotomy is when the perineum (the skin between the anus and the vaginal opening) is deliberately cut with a pair of sharp scissors. This will widen the vaginal opening, allowing the clinician to apply the forceps.
In some rare situations an episiotomy will not be carried out before a forceps delivery. Normally this will be because there is not enough time to perform an episiotomy.
3rd degree tear from forceps delivery
Unfortunately even with an episiotomy, the use of forceps can stretch the perineum to such an extent that it tears badly. The more minor types of tear are called first and second degree tears. The more serious types of tear are called third and fourth degree tears. Forceps deliveries are most commonly associated with 3rd degree tears, which is when the tear runs from the vaginal opening and down into the external anal sphincter.
It was previously thought that an episiotomy would help to prevent a 3rd degree tear. This is no longer considered to be the case. An episiotomy is not carried out to prevent a 3rd degree tear; rather, it is simply necessary to widen the vaginal opening. In some cases an episiotomy can actually increase the risk of a 3rd degree tear. Indeed, the risk is increased if a midline episiotomy is performed, which is when the cut is made straight downwards. However, midline episiotomies are not practiced in the UK anymore.
Is a 3rd degree tear negligent?
If you do suffer a 3rd degree tear during a forceps delivery, it will not be considered negligent. It is an unfortunate but accepted risk of childbirth. But what will be considered negligent is if the injury is not diagnosed and repaired shortly after the birth. If this has happened to you, you must speak to a solicitor as you could be entitled to compensation.