Third degree tears will affect approximately 2% of women in the UK every year. The reason why the injury is sustained by some women and not others is not always clear. However, there are certain risk factors that increase the chance of a third degree tear happening.
How do third degree tears happen?
During a vaginal delivery, the perineum and the vaginal opening will stretch to allow the baby to be born. In the majority of women, the vagina will be unable to stretch far enough to allow the baby’s head to emerge. Consequently, the perineum will be put under significant strain, eventually causing it to tear.
Most women will tear to some extent during a vaginal birth. In fact, the Royal College of Obstetricians and Gynaecologist (RCOG) estimate that as many as 90% of women will suffer some sort of tear. Most will suffer a superficial tear, known as either a first or second degree tear. But in around 9% of patients the tear will be much deeper, extending into the anal sphincter complex. These injuries are known as third and fourth degree tears.
It cannot be predicted who will sustain a third degree tear, and for most patients the reason they suffered such an injury is unknown. Nevertheless, there are various factors that increase the risk of third degree tears, including:
- First time having a vaginal birth
- Fast birth
- Prolonged second stage of labour
- Assisted delivery – e.g. forceps or ventouse delivery
- Large baby
Is a third degree tear negligent?
No one wants to experience a third degree tear, and if it has happened to you, you may feel upset about the way the birth was managed. However, a third degree tear is not normally the fault of medical practitioners; third degree tears are sadly an unfortunate but recognised risk of vaginal births.
On the other hand, medical practitioners will be to blame if the injury was not diagnosed and treated shortly after the delivery. Indeed, it is the duty of midwives and doctors to:
- Check a patient for tears after the birth
- Accurately identify any tears
- Organise the correct type of repair
If this level of care is not achieved, meaning a patient is discharged home with an unrepaired tear, there will be a breach of duty. If this causes a patient to suffer further harm, there will be grounds for a medical negligence claim.
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