There seems to be a contradiction between the aims of the ‘Better Births’ initiative and the current crisis on midwife numbers. What impact will this have on the rate of perineal tears?
The ‘Better Births’ initiative
The ‘Better Births’ initiative introduced by NHS England aims to improve outcomes of maternity services in England and focuses heavily on the role of the midwife.
Personalised care for each expectant mother, planned and overseen by her midwife is a central core of the Better Births concept. Continuity of midwife care from a small team of community-based midwives who can support the new mother before, during and after the birth is also a key aspect of the initiative.
The midwife is expected to be central to the well-being of the mother and essential to the successful communication between all professionals necessary to bring about the best outcome for mother and child.
However, there is currently estimated to be a shortage of approximately 3,500 midwives in England, a situation considered by the Royal College of Midwives to be inadequate to provide a ‘safe and high-quality maternity service’.
At the same time, there has been some suggestion that the rate of severe perineal tears experienced during vaginal childbirth has been increasing.
Midwives and the birth experience
Suffering a perineal tear is not uncommon during childbirth and even severe perineal trauma is not always unavoidable where the mother is carrying a large baby or requires an instrumental delivery.
However, the role of the midwife is crucial in supporting the pregnant woman both in preparing for the birth and during the birth in ways which might reduce the chances of a perineal tear occurring. The midwife may well offer advice as to exercise and massage which might increase the flexibility of the perineum before the birth. She may also advise on the best birthing position to try to avoid perineal damage.
The midwife can also be crucial in the diagnosis of any damage once the birth has been achieved. All women who have given birth vaginally should undergo a thorough examination of the perineum and anus after the birth to ensure that any damage is identified accurately. Without this measure, the woman will not receive a repair to her perineal injury and may find that she subsequently suffers incontinence of wind and faeces because her anal sphincter muscles had been damaged during the birth and nobody noticed.
If numbers of midwives are dropping and the pressure on those who remain increases because of this, it is hard to see how this can offer a positive outlook for pregnant women.
If you suffer a severe perineal tear – a 3rd or 4th degree tear – which is not diagnosed or repaired at the time of the birth, leading to distressing and unpleasant symptoms, you may be entitled to make a claim for compensation.
If this has been your experience, contact us to talk to a specialist medical negligence solicitor with experience in supporting claims for perineal injury.
Make A Free Enquiry
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.