If you have suffered a third or fourth degree tear because of a midline episiotomy, you could be entitled to pursue a claim for compensation. This is because midline episiotomies are no longer considered acceptable, and medio-lateral episiotomies must be carried out instead.
Who has an episiotomy?
An episiotomy is an incision into the perineal tissues that is designed to increase the vulval outlet in order to assist the birth of a baby.
This procedure was previously very popular as it was considered useful in protecting the pelvic floor during birth. Rates of up to 90% were recorded in the 1970s when the procedure was considered to be a routine intervention.
Over the years research has demonstrated that episiotomies are associated with complications such as poor anatomical healing, pain during sex, perineal pain and blood loss. As a result the rate of episiotomies has dramatically reduced.
Nowadays, an episiotomy is only performed in the UK when there is a significant delay in the delivery, or if there is an indication of foetal compromise and there is a need to expedite the birth. Routine episiotomy is no longer acceptable and must only be carried out if there is a clinical need to do so.
Midline vs medio-lateral episiotomy
In the UK, midwives and obstetricians are taught to perform a medio-lateral episiotomy as this is least likely to increase the risk of third and fourth degree tearing. This incision begins at the midpoint of the fourchette and is directed at an angle of 45 degrees away from the midline towards the patient’s buttocks. The perineum can be distorted when stretched, so if there is any uncertainty a midwife must seek a more senior midwife or doctor.
Midline episiotomies begin at the fourchette and are directed straight downwards. Midline episiotomies are practiced in countries such as the United States but are not considered appropriate in the UK as they are associated with a six fold increase in the risk of third and fourth degree tears.
Midline episiotomies are therefore not acceptable practice in the UK.
Claiming compensation for a midline episiotomy
Despite this, there are times when midwives and doctors will mistakenly carry out a midline episiotomy. In such cases the level of care will be deemed substandard. If this leads to further complications – such as a third or fourth degree tear – there will be a case of medical negligence.
If this has happened to you, please get in touch with us today to discuss your options.