An epidural for pain relief during childbirth has traditionally been thought to cause a longer second stage of labour and a greater need for the delivery to be assisted with either forceps or a ventouse. Both these factors – a protracted second stage and an assisted instrumental delivery – are seen as risk factors in receiving a severe obstetric injury, such as a third degree tear.
Severe tears in childbirth
Third and fourth degree tears are the most severe forms of perineal injury which can affect women during childbirth. Both of these tears describe an injury that splits the skin and muscle from the vagina to the anus, including the anal sphincter and, in the case of a fourth degree tear, the internal lining of the anal canal.
If a severe tear is not diagnosed and repaired at the time of the birth, it is likely that the woman will start to experience the distressing symptoms of wind and faecal incontinence, needing to have constant close access to a toilet. This can affect both a woman’s professional and private life dramatically.
Epidurals and the second stage of labour
Thankfully, however, recent research by the Beth Israel Deaconess Medical Center in the United States, has shown that giving a woman a pain-relieving epidural during the birth of her child does not, in fact, extend the second stage of labour, nor, therefore, is it likely to increase the risk of a severe perineal tear. This is likely to be welcome news to women considering having children as pain relief is currently often reduced in the second stage of labour in order to avoid subsequent impact on the development of the labour.
Epidurals and the birthing position
Further epidural-related news this month, as revealed in The Times, suggests that, when a woman has had an epidural during labour, she is more likely to go on to have a natural delivery – without forceps or ventouse – if she lies down rather than remaining upright.
This could be further good news for women trying to avoid suffering a severe perineal tear.
The birthing position has long been considered significant in increasing or decreasing the chances of perineal injury occurring with a squatting position considered to increase the chances of a severe tear occurring. An upright position would seem to reduce the length of the second stage of labour and reduce the need for an assisted delivery. A lateral position – lying on their side – seems to reduce the chances of a tear occurring.
So, it appears that having an epidural is unlikely to have contributed to a woman receiving a third or fourth degree tear.
Furthermore, it seems that women giving birth can look forward to more pain-relief without the fear that it may lead to a life-changing perineal injury.
If you experienced a severe tear during labour which was not diagnosed or effectively repaired, you may still be suffering the appalling long-term effects of loss of bowel control.
Contact Glynns Solicitors to discuss your experience with a specialist medical negligence solicitor. You may be entitled to make a claim for compensation.