If a midwife failed to diagnose your third degree tear, meaning the injury was only detected after you left hospital, you could be entitled to claim compensation for the pain and suffering you have been caused.
Should midwives recognise a third degree tear?
In order to verify whether a perineal tear has occurred, a patient must undergo a visual and physical examination, which should include a digital rectal examination. Sometimes this will be performed by a doctor, but commonly it will be carried out by the attending midwife.
All midwives should have a thorough understanding of perineal tears. A competent midwife should therefore have enough knowledge and expertise to spot a perineal tear, and to determine whether the injury is a first, second, third or fourth degree tear.
If there is any doubt in the mind of the midwife, further advice should be sought from a senior doctor. Ordinarily, however, a midwife should be able to recognise when a third degree tear happened.
Can midwives repair third degree tears?
If a third degree tear is diagnosed, it must be repaired as soon as possible. This cannot be done by a midwife because it is a complex injury that extends to the anal sphincters. Instead, an experienced surgeon must complete the repair in theatre.
Nevertheless, midwives play a crucial role in the after-care of a third degree tear. For example, they should ensure a patient knows how to keep the wound clean, how to prevent infections and how to speed up a recovery with pelvic floor exercises.
Once a patient is at home, the community midwife should check the wound is healing properly. A patient should be asked whether she is experiencing any problems and, if necessary, an examination performed.
Midwife negligence and third degree tears
Unfortunately, however, there are times when midwives provide a negligent standard of care, leading to a compensation claim. Often such claims revolve around a missed diagnosis, meaning a midwife has:-
- Examined a patient after the delivery but failed to identify any damage; or
- Examined a patient after the delivery but wrongly diagnosed a first or second degree tear; or
- Failed to examine the patient after the delivery whatsoever.
There are also times when problems are not detected by community midwives during home visits despite the fact a patient has reported complications.
If you have been diagnosed with a third degree tear and this was initially missed by the midwife, you could be entitled to claim compensation for the damage this has caused. Contact us to find out more.
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