Perineal trauma sustained during childbirth can blight a woman’s life if it is not diagnosed and repaired promptly. Careful perineal car during the birth may help to prevent this distressing injury.
Severe perineal tears
Severe tears which occur in childbirth cause damage to a woman’s anal muscles. Classified as third or fourth degree tears, they will tear the skin and muscle across the perineum as well as injuring the anal sphincter muscles and, possibly, the lining of the anal canal.
They require urgent, competent repair in order to avoid a possible lifetime of bowel incontinence.
OASI Care Bundles
Recently-designed care bundles proposed by the Royal College of Gynaecologists and Obstetricians endeavour to reduce the occurrence of perineal tears as well as emphasising the need for accurate diagnosis of any injury.
With regards to care of the woman’s perineum during childbirth, the guidelines recommend the use of manual protection of the perineum.
The following procedures might also be useful:
- Applying a warm compress to the perineum during the second stage of labour
- Perineal massage during the second stage of labour
Use of episiotomy
The care bundle also recommends the use of an episiotomy where this is considered to be appropriate, but this should be a medio-lateral episiotomy cut at an angle of 60° rather than a midline episiotomy.
Diagnosis of perineal tears
A perineal tear cannot always be avoided. Therefore, the need for a careful examination of the new mother is absolutely imperative in order to assess for any damage.
A post-natal examination of the perineum should include a digital, rectal examination without which signs of a 3rd or 4th degree tear might be missed.
Without an accurate diagnosis, there is no guarantee that the injured woman will receive a thorough repair. Without a thorough repair, the woman may need surgery at a later date which is unlikely to be as effective.
Such a failure to examine the woman effectively, leaving her with an unrepaired severe tear can mean that she will start to suffer wind and faecal incontinence. This can have a dramatic impact on her professional, personal and social life, not to mention impacting on her ability to raise her child. It may also be the cause of a claim for compensation.
If you are suffering the appalling long-term symptoms of a severe perineal tear, contact us to discuss your situation with an experience medical negligence solicitor.
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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.