Perineal Tear Treatment

90% of women experience a perineal tear during childbirth. What does this mean and how should it be treated?

What is a perineal tear?

A perineal tear is an accidental tear affecting the area around and between the vagina and anus which can occur naturally during vaginal childbirth.

Approximately 90% of women experience a perineal tear during childbirth but far fewer, about 5%, experience severe tears. Women giving birth for the first time are at a slightly higher risk of experiencing a severe tear.

There is evidence to suggest that incidences of perineal tears are increasing slightly which may be due to a variety of factors such as bigger babies or more accurate diagnosis.

"Before we contacted you we had no real idea that we had grounds for a medical negligence claim but after speaking to you it became clear that Wendy was indeed treated poorly. Chris Bird took the time to explain what was happening and kept us to speed. Our deepest gratitude to you all and Chris in particular."

Mr And Mrs H

If you have suffered a perineal tear and would like advice about a possible medical negligence claim, please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete a Free Online Enquiry.

Claims Involving Birth Tears That Glynns Solicitors Have Settled

How do perineal tears differ?

Perineal tears are graded according to how far they extend and the nature of the damage they cause, from a fairly superficial 1st degree tear to a severe 4th degree tear.

1st degree tears: these affect the skin of the perineum (the area between the vagina and anus) as well as possibly the lining of the vagina
2nd degree tears: these affect the skin and muscle of the perineum
3rd degree tears: these additionally affect the anal sphincter, the muscle controlling the anus and are sub-classified according to how much of the anal sphincter is damaged
4th degree tears: these are the most severe form of perineal tear and, as well as affecting the perineum and anal sphincter, additionally damage the internal lining of the anal canal

Treatment of perineal tears

How a perineal tear is repaired depends upon what type of tear has occurred; i.e. how much damage has been done.

A 1st degree tear may not need stitches and may heal naturally, especially if there has been little bleeding.

A 2nd degree tear will need stitches but this can be carried out in the delivery room. A 2nd degree tear should heal quickly and effectively.

In relation to severe tears, however, the most recent guidelines issued by the Royal College of Obstetricians and Gynaecologists state the following:

'Repair of third- and fourth-degree tears should be conducted by an appropriately trained clinician or by a trainee under supervision.

Repair should take place in an operating theatre, under regional or general anaesthesia, with good lighting and with appropriate instruments. If there is excessive bleeding, a vaginal pack should be inserted and the woman should be taken to the theatre as soon as possible. Repair of OASIS in the delivery room may be performed in certain circumstances after discussion with a senior obstetrician.'

Long-term Effects of Poorly Treated Severe Tears

Where a severe tear is not identified after the birth and, consequently, is not treated appropriately or at all, the long-term effects for the mother can be extremely distressing. If the anal sphincter has been damaged, the mother may find that she is unable to control her bowels either to prevent the release of wind or faeces.

Additionally, a fistula or hole, may develop between the bowel and the vagina, allowing faeces to leak out.

Assessing Perineal Tears

It is clear, therefore, that a careful examination of the new mother immediately after birth is vital to ensure an accurate assessment and repair is made of any tear.

The RCOG guidelines state that all women 'should be examined systematically, including a digital rectal examination, to assess the severity of damage, particularly prior to suturing.'

Without this attention to detail, the mother may suffer for years.

Medical Negligence

If you are suffering from the awful effects of an undiagnosed or poorly treated perineal tear, contact Glynns Solicitors to discuss your experience with a solicitor specialising in medical negligence claims. We have extensive experience of supporting claims for compensation for birth injury.

Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete a Free Online Enquiry.

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