Midwife Failure To Detect Perineal Tear
If a midwife has failed to correctly diagnose your perineal tear after a vaginal delivery, you could be in a position to make a compensation claim.
Types of perineal trauma
During a vaginal birth, the perineum will sustain some form of trauma. This will vary in severity from patient to patient, ranging from a first degree tear to a fourth degree tear:
- First degree: injury to the vaginal epithelium or perineal skin
- Second degree: injury to the perineum involving perineal muscles but not involving the anal sphincter
- Third degree: injury to the perineum involving the anal sphincter complex.
- Fourth degree: injury to the perineum involving the anal sphincter complex and anal mucosa.
Cloacal defect is when the perineal body is deficient and there is virtually no tissue between the vagina and the anus. This usually occurs as a result of a missed third or fourth degree tear.
Diagnosing perineal trauma after birth
After a vaginal delivery, a woman must be examined to ensure any perineal trauma is accurately diagnosed and appropriately treated. This can be carried out by either a doctor or a midwife.
If a doctor is not available, it is the responsibility of a supervising midwife to ensure a patient is thoroughly examined. This includes carrying out a rectal examination to assess that there is no injury to the anal sphincter complex. Sometimes on initial visualisation of the perineal area trauma may appear to be more superficial. However, it is possible for the trauma to extend deeply behind the intact perineal skin to involve the anal sphincters. This type of injury can be incorrectly diagnosed unless a thorough perineal and rectal examination is carried out.
Midwife failure to diagnose perineal trauma
Any reasonable, competent midwife should be able to carry out a thorough systematic perineal examination, including a rectal examination, in order to identify the full extent of trauma sustained during a vaginal birth.
If a midwife does not do a thorough examination and misdiagnoses a perineal tear (for example, diagnoses a first degree tear when it is actually a third degree tear) there will be a case of medical negligence. This is because the failure to recognise injury to the anal sphincter complex following a vaginal birth is unacceptable and represents a substandard level of care.
Have you had a misdiagnosed perineal tear?
If you have suffered a misdiagnosed perineal tear, you need to speak to a solicitor about the options available to you, as you will be considered the victim of medical negligence. This means that you will be entitled to claim compensation for the damages you have incurred.
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