A fourth degree tear is a severe perineal injury sustained by a woman during childbirth. In this article we explore fourth degree tears in more detail.
Perineal tears during childbirth
The perineum is the area of tissue between the vaginal opening and the anus. During a vaginal birth the perineum will stretch as the baby is delivered. However, the perineum can only stretch so far and sometimes the tissue will simply rupture. This is known as a perineal tear.
There are varying degrees of perineal tear, with the majority of women suffering a first or second degree tear. These are more minor injuries that involve the superficial layers of skin and muscle. Around 9% of women will suffer a more serious injury, which can be classified as a third or fourth degree tear.
What is a fourth degree tear?
A fourth degree tear is the most severe type of perineal tear. The Royal College of Obstetricians and Gynaecologists (RCOG) define as fourth degree tear as an injury that extends from the vaginal wall to the anal canal and rectum. It is therefore a large laceration that involves the vagina, perineum, external anal sphincter and internal anal sphincter.
Because it is such a severe injury, a fourth degree tear must be repaired in theatre by an experienced surgeon. This should be carried out shortly after the birth, although it should not interrupt mother-child bonding.
Recovering from a fourth degree tear
Once repaired, a fourth degree tear will be sore for another couple of months. Passing a stool may be difficult, necessitating the use of laxatives. It is not usually possible to resume sexual relations immediately and even sitting down can be painful for the first week. Nevertheless, most women who have a primary repair of a fourth degree tear will go on to make a full recovery.
Complications will arise, however, if the injury was not repaired before a woman left hospital. This only ever happens if medical professionals fail to diagnose the tear – either because a post-delivery examination was not performed, or it was performed by an incompetent midwife/doctor.
If a fourth degree is not diagnosed and treated shortly after the birth, a woman will develop problems such as the inability to control wind and faecal incontinence. A repair can be carried out subsequently, although it will be less effective than a primary repair (i.e. a repair carried out soon after the birth.
Fourth degree tear claims
Anyone who develops complications because their fourth degree tear was not diagnosed and treated by medical professionals will be considered the victim of medical negligence. The affected individual will therefore be entitled to pursue a claim for compensation. To find out more, contact us today.
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