Can a forceps or ventouse delivery cause a third degree tear?
Severe perineal trauma – third and fourth degree tears – is thought to occur in around 5% of vaginal births. Some argue that the percentage is even higher.
The area around the vagina needs to stretch as a baby is born so it is impossible to guarantee that no perineal trauma will occur but there would appear to be certain factors that increase the risk of a severe tear.
One of these factors is an instrumental delivery.
What is an instrumental delivery?
An instrumental delivery is where a medical practitioner decides that the mother may have difficulty delivering the baby completely naturally and uses medical equipment to help the birth.
This might be the use of a ventouse (a suction cap) which is applied to the baby’s head to allow the attending medical practitioner to help pull the baby out. Alternatively, it might refer to the use of forceps (similar to a large pair of tongs) which are applied to the sides of the baby’s head for the same purpose – to assist the medical practitioner in easing the baby’s passage into the world.
Why is an instrumental delivery necessary?
The use of forceps or a ventouse would suggest that the process of labour is not going smoothly and that the baby is reluctant to be born.
It might be that the baby is large or that it has become stuck behind the pubic bone and the mother needs assistance in order to complete the birth.
It may be that labour has become protracted and the mother is tired.
Impact of an instrumental delivery
An instrumental delivery is a recognised factor in the occurrence of severe perineal trauma.
An instrumental delivery may also mean that the medical professional decides to give the mother an episiotomy (a surgical cut to the perineum) in order to reduce the likelihood of perineal trauma.
However, there is some evidence that an episiotomy may increase the risk of severe perineal trauma i.e. third and fourth degree tears.
An instrumental delivery may increase the risk that the woman could develop long-term bowel dysfunction due to the damage which severe perineal tears cause to the anal sphincter muscles.
It is vital that a mother who has had instrumental assistance with the birth of her baby is given a thorough examination after the birth. This should include a digital rectal examination to check for any anal damage. Severe perineal trauma can cause internal damage to the anal sphincter and anal canal lining and a cursory external examination will not reveal this.
Speak to a solicitor
If you are suffering the long-term effects of a third or fourth degree tear because you were not accurately diagnosed at the time of the birth, you may wish to consider making a claim for compensation.
Contact us to discuss your experience with a solicitor who specialises in obstetric anal sphincter injuries.
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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.