Many different factors influence a woman’s chances of suffering a perineal tear during childbirth. Her choice of birthing position is probably one of them.
Statistics currently suggest that up to 6% of women giving birth vaginally will suffer a severe tear to the perineum and anus during the birth. Some experts suggest that the incidence could be higher and increasing.
With approximately three-quarters of a million births every year in the UK there is considerable interest in why severe tears occur and whether they can be prevented.
What is a severe tear?
A severe perineal tear is one which injures the woman’s anal muscles as well as the skin and muscle of her perineum between the vagina and anus. A 3rd or 4th degree tear is considered to be significantly more serious than a 1st or 2nd degree tear as it can detrimentally affect the woman’s ability to control her bowel.
A number of different factors are considered to contribute to the chances of a woman receiving a severe perineal tear during the birth of a baby. It seems more likely to occur in the following circumstances:
- It is the woman’s first vaginal birth
- It is a large baby
- It is an instrumental delivery
- The second stage of labour is prolonged
- The baby becomes stuck behind the pubic bone (shoulder dystocia)
The birthing position
An additional factor may be the position in which the mother chooses to give birth. Research would seem to suggest that some positions are more likely to result in a serious perineal injury.
According to the Royal College of Midwives, the following scenarios are likely to have either a positive or a detrimental impact on the well-being of the mother.
- Adopting a squatting position with a birthing chair seems most likely to contribute to a woman suffering a severe tear or perineal damage of some degree.
- Giving birth lying on one’s side (the lateral position) seems to be the position that will mostly reduce the chances of the mother suffering a severe tear.
- Upright positions for giving birth may contribute to a shorter second stage of labour, fewer instrumental births and fewer episiotomies, all of which may otherwise increase the chances of a severe tear.
Assessing perineal injuries
All women should be examined for evidence of perineal injury following childbirth. Where injury is noted, it should be recorded accurately in order to ensure that the appropriate type of repair is carried out as soon as possible
In the case of a severe 3rd or 4th degree tear, this will mean a surgical repair in an operating theatre.
Where a perineal injury is not detected or is misdiagnosed, the woman can be left with catastrophic lifelong symptoms of pain, urgency, incontinence and lack of control of wind.
In this scenario, the woman may be able to make a claim for compensation for substandard care.
Contact us to talk with a specialist medical negligence solicitor if this has been your experience.
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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.