Will new government plans for extra midwives improve rates of severe perineal trauma during childbirth?
The Royal College of midwives has estimated the current shortage of midwives across the UK at approximately 3,500.
In an attempt to respond to this shocking deficit, the government has just announced plans to train an extra 3,000 midwives over the next four years, starting with 650 training places being created in 2019.
This should go some way towards assisting the National Maternity Review aim of ensuring continuity of care:
‘every woman should have a midwife, who is a part of a small team of 4 to 6 midwives, based in the community who knows the women and family and can provide continuity throughout the pregnancy, birth and postnatally.’
But will it help to reduce the rates of severe obstetric injuries during childbirth?
Obstetric Childbirth Injuries
Severe perineal tears, also classified as third and fourth degree tears, occur in approximately 5% of vaginal births.
They cause injury to the anal sphincter and, in the case of fourth degree tears, the internal anal canal, and can cause symptoms of wind and faecal urgency or incontinence for the woman who is affected.
Accurate diagnosis is vital and can be achieved through a thorough post-natal examination of the perineum and anus. Guidelines issued by the Royal College of Obstetricians and Gynaecologists recommend the automatic use of a digital, rectal examination to check the condition of the anal muscle and lining.
Nonetheless, these severe and potentially life-changing injuries are frequently missed or misdiagnosed by the obstetricians and/or midwife attending the birth.
New initiatives to try to address this issue include OASI care bundles encouraging the automatic use of perineal examination after vaginal childbirth.
The need for better and broader awareness of the prevalence and impact of severe perineal tears is recognised as is the need for more thorough training of medical professionals as to the diagnosis of these distressing injuries.
A brighter future?
An increase in the number of midwives has surely got to be a good thing, assuming that the increase does more than compensate for the numbers who are currently leaving the profession.
However, for increased numbers to equate to an improved diagnosis of perineal trauma, better training also seems to be necessary.
A failure to diagnose a third or fourth degree tear can leave the injured woman with permanent, debilitating symptoms and may be the cause for a claim for compensation.
If you are suffering the long-term symptoms of a misdiagnosed tear, contact us to discuss your experience with a solicitor who specialises in obstetric trauma.
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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.