If you have had a third degree tear, you may be worried about having another vaginal delivery in the future. In this article we explore what advice is given to women regarding future deliveries after a third degree tear.
Can I give birth vaginally after a third degree tear?
If you have had a third degree tear, the mode of future deliveries will depend upon your current condition.
Generally speaking, as long as a woman has fully recovered from a third degree tear when she falls pregnant again, she can go on to have another vaginal delivery without problem. However, if a woman is still symptomatic when she falls pregnant again, she will need to discuss her options with an obstetrician. It is very likely that an elective Caesarean section will be recommended as another vaginal delivery could aggravate existing symptoms.
Complications from a third degree tear
According to the Royal College of Obstetricians and Gynaecologists (RCOG), around 60 to 80% of women who have had a sphincter repair are asymptomatic within 12 months of giving birth. Therefore the overwhelming majority of women in the UK will be able to have another vaginal delivery after a third degree tear.
But unfortunately 20 to 40% of women will continue to suffer complications a year after having sustained a third degree tear. These complications include faecal leakage, faecal urgency and incontinence of flatus (wind) and faeces. This is more likely in women whose third degree tear was not detected and repaired shortly after the birth.
Missed third degree tears
A missed third degree tear often leads to complications because the injury has not been repaired, meaning the anal sphincter and perineum remain torn. This will compromise sphincter function and will cause pain during sexual intercourse. When the injury is finally diagnosed, a repair can be carried out (called a secondary repair). Nevertheless, this will not be as effective as a repair performed soon after the delivery (called a primary repair).
If you have continuing complications because your third degree tear was not diagnosed, you will need a C-section for all future deliveries.
Claiming for a missed third degree tear
It is important to note that it is unacceptable for a third degree tear to be missed by medical professionals. All midwives and doctors should be able to diagnose a third degree tear during a routine examination, which should be performed before a new mother leaves hospital. A failure to do so will amount to medical negligence. If this has happened to you, contact us to discuss your options.
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