Midwives cannot repair third and fourth degree tears but they should be able to diagnose them. If a midwife fails to identify such an injury meaning it remains unrepaired, there will be grounds for a medical negligence compensation claim.
Examination after birth
Following a birth, a midwife must examine the genital tract in order to identify the extent of any trauma.
It is important that this examination is thorough as there will not be a further opportunity to observe and examine the area. This applies even if the trauma appears to be superficial and thus does not require suturing. It is easy to overlook serious damage, as tissue that looks intact can be concealing a fourth degree tear.
During the course of this examination, it is standard practice to perform a digital rectal examination. This will reveal the presence of good anal sphincter tone, and will ensure that there is no opening between the vagina and the rectal wall.
By inserting a finger into the anus, the midwife should be able to identify whether the tone of the sphincter is good. If the sphincter feels loose or is lacking in tone then the possibility of sphincter damage should be considered. Advice from a doctor should then be sought.
Failure to diagnose perineal tear
An average midwife in the UK should be competent enough to recognise perineal trauma, and diagnose the extent of the injury. This should be categorised as a first, second, third or fourth degree tear. If the anal sphincter or canal is damaged, the patient should be referred to an experienced obstetrician for repair.
Unfortunately, however, a midwife will not always make an accurate diagnosis. For example, a patient may be told she has no trauma whatsoever and so does not require suturing; alternatively a patient may be told she has a minor tear, when in fact she has a third or fourth degree tear.
A wrong diagnosis often happens because a midwife fails to:-
- Carry out any sort of examination
- Carry out a digital rectal examination
- Fails to accurately assess the injury
Claiming for a missed tear
If your perineal tear was missed, or it was wrongly diagnose as a first or second degree tear, you could be entitled to pursue a claim for compensation. A competent midwife in the UK should be able to detect a tear and correctly classify the tear. A failure to do so will amount to medical negligence.
If this has happened to you, please get in touch with us today to discuss making a compensation claim.