Research suggests that perineal trauma in childbirth, especially severe perineal tears, has been increasing in the UK.
What is the role of the midwife in both contributing to and resolving this issue?
Midwives in the UK
Midwives are experts in pregnancy, childbirth and postnatal care of both mother and child. Their role in the birth of a child is crucial to the well-being of both mother and baby.
However, there is currently estimated to be a shortage of approximately 3500 midwives in the UK, which much surely impact on the experience of women going through childbirth as well as putting significant pressure on the midwives themselves.
In addition, it has been suggested that midwife training with regards to perineal trauma may have been insufficient in the past.
Are these factors going to increase the chances of some women suffering from severe perineal trauma during childbirth?
Responding to perineal tears
Many women suffer perineal tears during vaginal childbirth but a competent repair can mean all symptoms are resolved within 12 months. In order for this to occur, the extent of the tear needs to be diagnosed accurately in the immediate aftermath of the birth. With fewer midwives under greater pressure, is there a danger that more 3rd and 4th degree tears will be missed?
The Better Births initiative emphasises the importance of ensuring continuity of midwife for pregnant women, who can liaise with other medical professional and care providers to ensure good quality care for the new mother.
OASI care bundles
Another recent attempt to prevent and respond to severe tears (otherwise known as Obstetric Anal Sphincter Injuries) is the introduction of OASI care bundles by the Royal College of Obstetricians and Gynaecologists.
The OASI care bundle suggests key strategies for midwives and obstetricians for reducing the risk of severe anal injuries such as:
- Informing the woman about minimising her risk of a severe tear
- Using manual protection of the perineum during childbirth
- Using an episiotomy if appropriate
- Ensuring a thorough examination of the perineum after childbirth
Care Quality Commission Report 2018
The latest Care Quality Commission national survey into the quality of maternity care in the UK shows improvements in choice, continuity of carer and level of support provided to women giving birth.
Nonetheless, Mandy Forester, head of quality and standards at the Royal College of Midwives is reported as saying, “there is still much more that can be done to ensure women are experiencing the best possible care and treatment during their pregnancy.”
If you are suffering with the shocking long-term symptoms of a severe perineal tear due to a failure to diagnose, you may be entitled to make a claim for compensation.
Contact us now to discuss your experience with a specialist medical negligence solicitor.
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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.