Third degree tears are when the perineum, vaginal wall and anal sphincter tear during vaginal delivery. In this article we explore why third degree tears happen and if anything can be done to prevent them.
Why do third degree tears happen?
When a woman gives birth vaginally, her vagina must stretch to allow the baby to pass through. Sometimes the vagina is unable to stretch far enough, causing it to tear when the baby is delivered.
On other occasions, an episiotomy is performed to widen the vagina. This is a deliberate cut made by medical practitioners to the perineum. As the baby is delivered, it is possible that the episiotomy cut extends further than was intended, down into the anal sphincter.
Who will suffer a third degree tear?
The Royal College of Obstetricians and Gynaecologists (RCOG) predicts that each year around 9% of women in the UK will experience a severe tear while giving birth. A severe tear is either a third or fourth degree tear.
It is not possible to say who will, and who will not, suffer a third degree tear. Nevertheless, there are certain factors that increase the risk of a third degree tear happening. These include the following:
- First vaginal birth
- Larger than average baby
- Labour is induced
- Second stage of labour is longer than expected
- Assisted birth (e.g. forceps or ventouse delivery)
- Shoulder dystocia
Can a third degree tear be prevented?
Even if a woman has one or more of these risk factors, it is unlikely that a third degree tear can be prevented. If the labour is not progressing well – for example, the second stage of labour is prolonged – medical practitioners should proceed to an emergency Caesarean section. In most other situations, however, it is not possible to prevent a third degree tear.
Previously, it was thought that an episiotomy would help to prevent severe tears. This is no longer considered to be accurate. Although an episiotomy does create more room for the baby to be born, it will not stop a third degree tear from happening.
Third degree tears and medical negligence
Third degree tears do regularly lead to medical negligence claims. However, such claims do not normally arise because the tear has happened. Rather, third degree tear claims arise because medical practitioners have failed to diagnose and repair the injury. A third degree tear that remains undetected (and thus unrepaired) will be deemed negligent and the affected individual will be entitled to pursue a compensation claim.
If you have been harmed because of a missed third degree tear, please get in touch with us today.