Approximately 90% of women are thought to suffer perineal trauma during childbirth. What is the current thinking on how to reduce this statistic?
Perineal trauma during childbirth
Preventing any form of perineal trauma would be difficult indeed. Most women suffer a tear to the perineum of some degree during vaginal childbirth and an unfortunate few suffer a severe tear.
Certain circumstances contribute to the chances of a severe tear occurring such as the following:
- Giving birth to a large baby
- Needing an instrumental delivery (ventouse or forceps)
- Shoulder dystocia during birth (where the baby’s shoulder becomes stuck behind the woman’s pubic bone)
- A prolonged second stage of labour
Preventing perineal tears
However, there are a number of procedures which might reduce the chances or severity of a perineal tear as assessed and discussed in the recent World Health Organisation Guidelines.
- Massage of the perineum undertaken by the midwife during the birth would appear to increase the chances of the perineum remaining intact and may even help to reduce the occurrence of severe 3rd or 4th degree tears.
- The use of a warm compress on the perineum during childbirth can also help to reduce the incidence of severe obstetric injury
- An upright birthing position may reduce the need for an instrumental birth or an episiotomy but may increase the chance of a 2nd degree perineal tear but have little effect on the chances of suffering a severe tear
- A lithotomy position (lying on the back) may increase the risk of a severe 3rd or 4th degree tear
- A squatting birthing position or use of a birth seat may also increase the risk of a severe anal sphincter injury
- A lateral position (lying on the side) may reduce the risk of an anal sphincter injury occurring
- Selective use of episiotomy may reduce the rate of severe perineal trauma
Diagnosing perineal trauma
If a new mother has been unfortunate enough to have received a severe obstetric injury during the birth of her child, it is imperative that the injury is identified and accurately diagnosed immediately after the birth.
A failure to repair or a significant delay in repairing any injury may leave the woman with a lifetime of significant bowel problems.
Where this occurs, the woman may be entitled to make a claim for compensation.
Contact us to discuss your situation if this has been your experience. We have supported numerous women in compensation claims for misdiagnosed perineal trauma and would 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.