A third degree tear is a severe injury to the perineum and anal sphincter that is sometimes experienced by women giving birth vaginally, especially for the first time. Does such an injury ever heal?
Rates of recovery
The Royal College of Obstetricians and Gynaecologists guidelines on managing severe perineal tears states that ’60 – 80% of women are asymptomatic 12 months following delivery and EAS (external anal sphincter) repair.’ This means that the majority of women do find that their birth injury has healed after a year, although it may be sooner.
However, this assumes that:
a) Your tear has been diagnosed accurately and is a 3a or 3b tear and does not affect the internal sphincter
b) The repair has been achieved to a good standard using appropriate techniques
It does not allow for the possibility that:
- you have suffered a 3c tear
- the repair has not been done to an acceptable standard
- you have been misdiagnosed and, in fact, you have suffered a fourth degree tear
In these circumstances, you may find that you do not make a full recovery as part of your injury has not been repaired.
What if you have suffered a 3c tear?
If, in fact, you have suffered a 3c grade tear, your internal anal sphincter will also have been damaged. Your anal sphincter is the muscles which control your bowels and which are used in the passing of wind and faeces.
An internal anal injury may require a separate, skilled repair. It will be harder both to identify and to repair a 3c tear and extreme skill is required.
If you have received a substandard repair, due perhaps to lack of experience or training on the part of the medical practitioner, your repair may break down and you may start to experience symptoms of pain, infection and bowel incontinence such as urgency when needing to go to the toilet.
You may require additional surgery although this may not be as successful as it would have been had it been done competently in the first place.
If you have been misdiagnosed?
It is possible that you have been diagnosed with a third degree tear when you have actually suffered a 4th degree tear. A 4th degree tear causes all the injuries of a 3rd degree tear but additionally damages the internal lining of the anal canal.
It is difficult to diagnose a fourth degree tear, emphasising the need for extreme care in the post-partum examination of the mother.
If a 4th degree tear is not identified and repaired promptly after the birth, the woman can develop a fistula, leading to long-term leakage of faeces and wind via the vagina, causing significant embarrassment and distress.
A failure to diagnose a third or fourth degree tear may be regarded as providing substandard care and the woman may be entitled to make a claim for compensation should she subsequently suffer with the appalling symptoms of incontinence.
If you are experiencing these symptoms after the birth of your child, you may have suffered an undiagnosed or misdiagnosed perineal tear.
Contact Glynns Solicitors to discuss your situation. We have supported many women with compensation claims for perineal trauma in childbirth and would happy to offer you advice.