A perineal tear during childbirth can be a minor injury but it can also be severe, traumatic and cause life-long debilitating symptoms. Accurate diagnosis of any injury in the moments after childbirth is absolutely vital.
Misdiagnosis & Treatment
If a woman suffers a perineal tear during the vaginal birth of her baby and it is misdiagnosed, it can lead to significant problems. The correct classification of a perineal tear should ensure the correct type of repair. Given that some tears require repair in an operating theatre and some don’t, the impact of a misdiagnosis can be dramatic.
The Royal College of Obstetricians and Gynaecologists has issued descriptors for the accurate classification of perineal tears which should enable accurate diagnosis.
Classification of Perineal Tears
- 1st degree tear: injury to the perineal skin and/or vaginal mucosa
- 2nd degree tear: injury to the perineum involving perineal muscle
- 3rd degree tear: 3a – injury to the perineum including less than 50% of external sphincter thickness
- 3b – injury to perineum including more than 50% of external sphincter
- 3c – injury to perineum including both external and internal sphincter damage
- 4th degree tear: injury to perineum including anal sphincter and anorectal mucosa
In short, a third or fourth degree tear can leave the woman unable to control her bowels.
The impact of perineal tears
First and second degree tears usually repair quickly and fully leaving the woman with no on-going symptoms.
Third and fourth degree tears, otherwise referred to OASI (obstetric Anal Sphincter Injuries) can cause significant physical damage. Damage to the anal sphincter which is not expertly repaired shortly after the birth of a child can cause the following problems:
- loss of the ability to control the passing of faeces
- loss of the ability to control the passing of wind
- urgency when needing to go to the toilet
- infections of the perineum
- discomfort during sexual intercourse
- leakage of faeces from the vagina if a fistula subsequently develops between the bowel and the vagina
The impact of symptoms of this nature on a woman’s quality of life can be understandably traumatic. It is likely to restrict the nature of employment the woman can undertake, if any, as well as limiting her ability to travel, socialise and bring up her children in the way she may have wished.
Furthermore, the psychological impact of an undiagnosed severe perineal tear can be devastating.
Diagnosis of perineal injury after birth is the responsibility of the attending medical professionals. The woman should be given a thorough examination including a digital, rectal examination to ensure that any damage is identified and classified accurately. Only in this way will the woman have the greatest chance of a full recovery with no on-going symptoms.
If you are suffering with the appalling long-term symptoms of an undiagnosed or misdiagnosed severe perineal tear, you may wish to consider making a claim for compensation.
Contact us to discuss your experience with a specialist medical negligence solicitor who will be happy to advise you.
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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.