Does a third degree tear mean no more childbirth?
Although a perineal tear during childbirth is both natural and common, a severe tear can have significant long-term effects if undiagnosed or poorly treated. Does this include the inability to have further children?
What is a perineal tear?
A perineal tear can occur quite naturally during childbirth as the baby emerges through the vaginal opening. The vagina will need to stretch and sometimes the perineum (the area between the vagina and the anus) may tear. Most commonly, these tears only affect the vaginal lining and the skin or muscles of the perineum, and can probably be treated with stitches by the midwife or doctor.
A 3rd or 4th degree tear, however, is more severe and requires treatment in an operating theatre by an experienced surgeon. A 3rd degree tear will continue beyond a 2nd degree tear to affect the anal sphincter and a 4th degree tear will additionally impact on the lining of the anal canal (the mucosa). It is important to note that these more severe tears are rare and only approximately 3% of women experience them. As these tears are more extensive, however, it is understandable that they might also cause more significant long-term effects.
Recovery from a 3rd degree or 4th degree tear
Sixty to eighty per cent of women who experience a 3rd or 4th degree tear make a full recovery within 12 months but the injury must be identified promptly after the birth and competently treated to increase the chances of this happening. If a tear is missed or the surgical repair is inadequate, a number of significant effects can develop which might require further medical attention.
These effects could include:
- Inability to control wind
- Faecal incontinence, possibly requiring a colostomy
- Pain and discomfort when standing/sitting/walking for extended periods of time
- Pain/discomfort during sexual intercourse
An incomplete repair may also result in a fistula (a hole or passage) between the rectum and vagina, causing on-going infections and requiring further surgery.
Future childbirth after a 3rd degree tear
Experiencing a 3rd degree tear does not prevent you from having more children or from giving birth vaginally. However, it will increase the chances that you will experience a further tear should you opt for vaginal delivery of a child in future. You may choose to consider a caesarean section, especially if you are still experiencing some symptoms following your 3rd degree tear. You should discuss this with your doctor and/or midwife and consider all the options.
Aiding Recovery
It might be useful to try to help your body recover from your 3rd degree tear and surgery with the following methods:
- Pelvic floor exercises
- Eating a healthy, high-fibre diet to reduce pressure on the bowels and drinking plenty of fluids
- Being aware of hygiene to reduce the risk of infection and keep the perineum clean
It is clear, however, that the key to long-term recovery and confidence in future childbirth is for your medical practitioners to be diligent in checking your health after the delivery of your baby to ensure that you have not suffered a perineal tear and to organise prompt and competent treatment if you have.
Speak to a solicitor
If you feel that this may not have been the case with your birthing experience and you have been left with significant, on-going problems, contact us at Glynns to discuss your situation with a solicitor who specialises in birth injury claims.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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