Accurate diagnosis of perineal tears during childbirth is key to influencing the outcome for the injured mother. There is a big difference between a 2nd degree tear and a 3rd degree tear and a careful examination is required.
Comparing the nature of damage
The damage inflicted by a third degree tear is significantly worse than that caused by a second degree tear.
A second degree tear will injure the skin and muscle of the perineum, the area between the vagina and the anus, but will NOT impact on the anus itself.
A third degree tear WILL impact on the anus. A third degree tear will damage the perineum but will extend to injure the anal sphincter. This may be just the external sphincter or may also include the internal sphincter. The anal sphincter muscles control the opening and closing of the bowels and are, therefore, fundamental to the effective and hygienic functioning of the bowel.
Type of repair
A third degree tear, as implied by the severity of the damage mentioned above, necessitates a more complex type of repair than a second degree tear.
Where a second degree tear can be stitched by a midwife or doctor on the maternity unit shortly after the birth, a third degree tear must be repaired by an experienced surgeon in an operating theatre. It requires specific techniques and materials depending on the extent and location of the tear.
A woman with a second degree tear may well experience discomfort whilst her tear heals but should make a fairly prompt and full recovery.
Due to the nature of the injury caused, however, a third degree tear can leave a woman incontinent of both wind and faeces. If the tear has been misdiagnosed as a second degree tear and, therefore, inappropriately repaired, these symptoms may become long-term.
Where surgery is possible at a later date, it might require a temporary colostomy and may prove to be less effective than had it been observed and treated at the time of the birth.
Diagnosing tears accurately
The Royal College of Obstetricians and Gynaecologists’ guidelines suggest that every woman giving birth vaginally should undergo a thorough examination after the birth. This should include a digital, rectal examination to check for any signs of a severe anal injury.
Without such an examination, it continues to be possible for a woman to experience a severe tear without it being diagnosed or repaired.
Misdiagnosis and medical negligence
Where a severe tear is unobserved or misdiagnosed due to a failure to examine the woman after birth, it may be appropriate to make a claim for compensation.
Speak to a solicitor
If you are suffering with the long-term effects of a misdiagnosed severe perineal tear, contact us to discuss your experience with a specialist medical negligence solicitor.
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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.