The Agony of a Third Degree Tear Resulting From Childbirth
It's extraordinary what new mothers' will discuss amongst themselves. Across the country, at NCT coffee mornings, women who up until a few weeks ago were complete strangers find themselves describing their childbirth experience in intimate detail. And one of the main questions first asked is, “How many stitches did you get?”.
For most women, thankfully the answer to this is, “a few”. But for some, the repercussions of a tear in childbirth can last for months, years or even a lifetime.
The complex nature of third degree tears
Tears are common in childbirth and are categorised as first, second, third and fourth degree. A third degree tear is where the tear extends downwards from the vaginal wall and perineum to the anal sphincter, the muscle that controls the anus.
Third degree tears can be further divided into another three categories:
- 3a: less than 50% of the external anal sphincter torn
- 3b: more than 50% of the external anal sphincter torn
- 3c: both the external anal sphincter and the internal anal sphincter torn
Most women are not told what level of third-degree tear they have received.
Factors which can contribute to a tear occurring include:
- you have a large baby
- assisted delivery (forceps or ventouse) is required
- you have to push for a long time
- this is your first vaginal delivery
- the doctor performs an episiotomy
- your baby is born face up
- the distance between your vagina and anus is shorter than average
- you have torn previously as a result of childbirth
In a majority of cases, third degree tears cannot be prevented because they cannot be anticipated. However, if many of the risk factors are present, and a third-degree tear occurs, it may be because the medical team did not properly asses the risks of you giving birth naturally.
If you sustain a third-degree tear, once you have delivered your baby you will be taken to theatre to have it repaired. Doctors will want to know you have passed a stool before letting you go home.
Your midwife will perform check-ups to assess your stiches are healing. Depending on the severity of your tear, you may need to attend physiotherapy sessions at the hospital for some weeks following the birth.
The ramifications of third degree tears
Sustaining a third degree tear and the stitches that result from it can be excruciatingly painful. Many new mothers state that walking is difficult, sitting down is painful, and the only way to even contemplate urinating is to do so in the bath to alleviate the excruciating stinging sensation.
Fortunately, most women go on to recover fully, despite the initial discomfort for the first few weeks following the birth. But around 20% of women continue to have problems, which can devastate the quality of their lives.
These can include:
- pain experienced during sexual intercourse
- difficulty controlling the passing of wind and the need to rush to the toilet if you need to open your bowels
- severe pain in perineum, pelvis, and lower abdomen
However, the most devastating complication that can occur is an obstetric fistula. An obstetric fistula is a hole between the vagina and rectum or bladder which can leave a woman incontinent of urine or faeces or both.
Obstetric fistulas mostly occur in countries where medical attention is not readily available. It is usually caused by several days of obstructed labor, without timely medical intervention – typically a Caesarean section – to relieve the pressure. In over 90% of these cases, the baby dies and the women are left with chronic incontinence, shunned by society, often dying of infection and disease caused by the fistula being left untreated.
The World Health Organization has called fistula “the single most dramatic aftermath of neglected childbirth.”
Obstetric fistulas hardly ever heal by themselves, surgery is usually necessary to repair the damage. The condition is thankfully rare in the UK, but a small number of cases do occur every year.
Third degree tears and medical negligence
Failure to spot a third degree tear
A third degree tear should be identified and repaired in theatre immediately after delivery. Failure to do so is likely to amount to medical negligence.
After delivery, your midwife or doctor will examine your vagina and pelvic area to check for tears and other injuries. They should not miss something as serious as a third degree tear. In some cases, the third degree tear may be identified but only graded as a first or second degree tear. Third degree tears should always be repaired in theatre by a competent doctor, but if the extent of the tear is misdiagnosed, then a gap in the anal sphincter may remain because only part of the tear will be repaired.
If a third degree tear is missed, then major surgery involving reconstruction of the perineum may be required. However, this secondary repair of the defect in the anal sphincter does not offer a good long-term success rate, with only 40% of women reporting that they have little or no incontinence issues after five years.
Other treatments for a missed third-degree tear include direct sacral neuromodulation and a rectal irrigation device such as Peristeen.
Infection
If a third-degree tear becomes infected it is imperative that medical staff spot it and provide adequate treatment (antibiotics) and check for any underlying causes of the infection such as a fistula.
An infection can cause pain, fever and a breakdown of the stiches, which may require the tear to be repaired again. A reasonably competent GP or other health professional should recognise the symptoms of an infection surrounding a third-degree tear and treat it immediately. If he or she fails to do so they may be guilty of medical negligence.
Making a medical negligence claim
To make a claim for medical negligence you must prove, on the balance of probabilities that:
- 1. Your health professional owed you a duty of care;
- 2. He or she breached their duty; and
- 3. This breach resulted in you suffering harm.
If you believe that your third-degree tear and/or resulting complications was caused by negligence on the part of the health professional who treated you, then you may be entitled to compensation.
The first step to making a claim is to get in touch with an experienced law firm who acts for medical negligence victims.
At Glynns Solicitors we have the expertise required to successfully act for women who have received a third-degree tear caused by medical negligence. Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form and one of our solicitors will get in touch with you.
Make A Free Enquiry
If you believe that your third-degree tear and/or resulting complications was caused by negligence on the part of the health professional who treated you, then you may be entitled to compensation.
The first step to making a claim is to get in touch with an experienced law firm who acts for personal injury claimants.
At Glynns Solicitors we have the expertise required to successfully act for women who have received a third-degree tear caused by medical negligence.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
Make An Enquiry
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