The classification of a severe perineal tear as a more superficial tear can reduce a woman’s chance of making a good recovery from this unpleasant childbirth injury. It may also be the justification for a compensation claim.
Assessment of perineal trauma
Classification of perineal trauma in childbirth has been clarified to identify precisely the varying degrees of damage which can be sustained by a woman in the course of giving birth.
It is important that any damage to the perineum and anus is accurately identified and recorded according to guidelines in order to ensure an adequate repair. A misdiagnosis or misclassification of perineal trauma can affect the efficacy of any subsequent repair and leave the woman with incontinence problems.
Research has suggested that such misdiagnosis, or misclassification, does not generally occur where the examination of the new mother is undertaken by a specially trained clinician. Where the assessment is carried out by a midwife or junior doctor, however, the likelihood of a tear being missed or misdiagnosed in dramatically higher.
Classification of severe perineal trauma
Third and fourth degree tears cause damage to the anus, and thus may impact on the woman’s ability to control her bowels effectively.
These tears should be assessed and classified carefully as soon after the birth as possible.
The guidelines as are as follows:
Third degree tears:
3a tear less than 50% of the external anal sphincter thickness is torn (as well as the skin and muscle of the perineum which constitutes the damage of 1st and 2nd degree tears)
3b tear more than 50% of the external anal sphincter is damaged
3c tear both the external and internal anal sphincter is damaged
4th degree tear injury to the perineum involving external and internal anal sphincter and the lining of the anal canal
An assessment of a woman’s perineum after childbirth should include a digital, rectal examination to check for any anal sphincter or internal anal damage.
Should such damage have occurred, a thorough repair by an experienced surgeon, trained in this field, should take place in an operating theatre as soon as possible to ensure the most effective repair and long-term outcome.
Failure to carry out a thorough examination leading to an inaccurate diagnosis of perineal damage may leave the woman suffering life-changing symptoms of wind and faecal incontinence. This can affect the long-term quality of her professional and personal life.
Such a failing may be considered to be a breach of medical care and warrant a claim for compensation for the woman’s pain and suffering and on-going losses.
If you are suffering the long-term effects of a severe tear due to misdiagnosis, contact us to discuss to discuss your experience with a solicitor who specialises in perineal trauma claims.
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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.