Perineal tears are largely unpredictable, although there are a few ways in which to minimise the chance of a perineal tear happening.
Can third and fourth degree tears be prevented?
In the months leading up to the birth, a mother-to-be can massage the perineum on a regular basis. This will help to improve elasticity, allowing the perineum to stretch when the baby’s head and shoulders are being delivered, rather than tear. Doing pelvic floor exercises (sometimes called kegal exercises) is also beneficial as this will strengthen the pelvic floor.
During the birth itself, it is advantageous if the labour is slow and controlled. Pushing should not commence until the cervix is fully dilated because excess pushing will cause the perineum to swell, increasing the risk of a tear. It is also more likely that a tear will happen if an assisted delivery is needed, although this is not always something that can be avoided.
However, even with these precautionary measures, it is not always possible to prevent a perineal tear.
Does a third or fourth degree tear amount to negligence?
Therefore the occurrence of a third or fourth degree tear does not necessarily amount to negligence. Ordinarily such an injury will happen because it is an unfortunately but perfectly natural part of childbirth.
Nevertheless, there are times when a third or fourth degree will occur because of mistakes made by the medical team. For example, it might be that a doctor or midwife performs a midline episiotomy, rather than a medio-lateral episiotomy. This is no longer good practice as it increases the chance of a tear extending to the anal sphincter. This will therefore amount to negligence. The same may be true if an episiotomy was performed with blunt scissors, or there was no good reason for carrying out an episiotomy.
A third or fourth degree tear may also be deemed negligent if an assisted delivery was performed unnecessarily, or if the labour was progressing very slowly and an emergency C-section should have been carried out instead.
Failure to diagnose a tear
A medical negligence claim relating to a third or fourth degree tear may also arise if medical professionals actually fail to diagnose the injury before a woman is discharged from hospital. Often this will happen because a thorough examination is not performed, or because the medical professional doing the examination did not identify the injury. Either way this will amount to a substandard level of medical care.
If you believe you have been harmed because of the actions of medical professionals, get in touch with us today to discuss your options.
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