Protecting the Perineum From Birth Tears
A tear to the perineum is a risk of vaginal birth but it is worth considering ways in which this sensitive area of the body can be protected.
Why does the perineum need protection?
The perineum is the area between the vagina and the anus which comes under a lot of pressure during vaginal childbirth.
As the baby is born, the area around the vagina will need to stretch to allow the baby to be delivered and this is when injuries can occur. Up to 90% of women will suffer a tear to the perineum during childbirth but, for most women, this will be a small, superficial tear which may not even need stitches.
However, for up to 5% of women, the tear will extend over a greater area and cause significant damage to the perineum and the anus. This type of severe tear - known as a third or fourth degree tear - requires surgery to repair it.
Anything that can help protect the perineum against such injury needs to be considered both before and during the birth.
Protecting the Perineum
Before the Birth
During the last month of pregnancy it is recommended that women massage the perineum in order to try to improve the tone and flexibility of the skin and muscle so that it will expand more easily during labour. Evidence suggests that this can lead to a reduction in the number of women experiencing severe perineal injury. It may also reduce the need for an episiotomy - a deliberate cut to the perineum carried out by the midwife or doctor in order to ease the delivery.
During the birth
The Royal College of Obstetricians and Gynaecologists 'Guidelines for the Management of 3rd and 4th degree Tears' recommends an active 'hands-on' approach to manual support of the perineum during delivery, with the right hand protecting the perineum whilst the left hand controls the delivery of the baby's head.
The Guidelines also recommend the application of a warm compress during the second stage of labour which has been found to reduce the risks of third and fourth degree tears significantly. This method involves 'holding the compress on the perineum continuously during and between contractions.'
It is also considered possible that massage of the perineum during the second stage of labour may reduce the risk of a severe tear.
Repairing Damage
The reality is that it is not possible to completely remove the risk of a severe tear occurring and a small percentage of women will continue to experience them.
What is vital, however, is that such injuries are spotted, accurately diagnosed and effectively treated as soon after the birth as possible. In these circumstances, the mother has a good chance of a successful recovery.
Sadly, however, sometimes severe birth tears are not noticed or they are misdiagnosed as less severe injuries and the mother can develop extremely distressing long-term effects such as wind and faecal incontinence. With a delay in treatment, the chance of a full recovery is reduced.
Have you suffered a severe tear unnecessarily?
If you have suffered the appalling effects of a severe tear because your diagnosis was inaccurate or delayed, you may be entitled to make a claim for compensation for your on-going symptoms.
Contact Glynns Solicitors to discuss your circumstances. We are a specialist medical negligence team and have significant experience of supporting claims for poorly treated perineal tears.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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