The long-term symptoms of perineal trauma caused by childbirth can be highly unpleasant and extremely debilitating. Accurate diagnosis and repair are crucial to increasing the chances of recovery.
Perineal trauma in the form of tears to skin and muscle are a frequent occurrence in vaginal childbirth. Their severity is reflected in the classification of the tears from a 1st degree tear to a 4th degree tear.
The likelihood and extent of possible recovery can be linked to the degree of initial damage caused.
1st degree tears
First degree tears are tears to the skin between the vagina and the anus. Such injuries usually heal naturally, effectively and quickly.
2nd degree tears
Second degree tears are more severe and damage the muscle as well as the skin in the perineal area. However, they do not extend to cause damage to the anus. Such injuries are likely to require stitching by either the midwife or obstetrician but are expected to recover fully. Repair can take place on the maternity ward and do not require surgery in an operating theatre.
3rd degree tears
A third degree tear additionally damages the anal sphincter. These are the muscles which control the opening of the bowel and the passing of wind and faeces. A 3a tear will only damage the external sphincter whereas a 3c tear will damage both the external and internal sphincter.
All 3rd degree tears require repair in an operating theatre by an experienced surgeon. Repair of a 3c tear is more complex than a 3a tear and women with these injuries are less likely to make a full recovery than those with a 3a tear.
4th degree tears and rectal buttonhole tears
A 4th degree tear is the most severe form of tear damaging the anal sphincter as well as the lining of the anal canal. A rectal buttonhole tear may damage the lining of the anal canal but not the anal sphincter muscles. Both forms of injury require a highly-skilled repair to avoid the development of a fistula between the rectum and the vagina which can cause long-term leakage of wind and faeces via the vagina.
These forms of injury are associated with a poorer long-term outcome and less recovery of bowel function.
However, the Royal College of Obstetricians and Gynaecologists has indicated that, with a prompt and effective surgical repair, 60% – 80% of women are free of symptoms within 12 months of the birth.
Given that up to 10% of women are thought to experience severe obstetric damage during childbirth, a careful examination for any signs of injury is vital as soon as possible after the birth.
Without an accurate diagnosis, a full and effective repair is much less likely to take place, leaving the woman with on-going symptoms of wind and faecal incontinence.
Speak to a solicitor
If you are suffering with such symptoms due to a failure to diagnose or repair your severe perineal tear, you may wish to consider making a claim for compensation.
Contact us to discuss your situation with a specialist medical negligence solicitor with expertise in perineal trauma cases.
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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.