Injuries to mother: Perineal tear claims

Perineal tears involve trauma to the perineum (the area between the vagina and anus) during childbirth. Although tears are common, occurring in 90% of women and cannot always be avoided, they differ in severity and can have adverse affects on women post delivery.

Perineal damage is more likely to occur when women are giving birth for the first time or who have a baby with a birthweight of over 4kgs, an instrumental delivery or prolonged second stage of greater than two hours.

The classification of perineal tears is dependant upon the extent of the trauma. The least severe perineal tear is known as a first degree tear. This involves just the skin layer of the perineum tearing. It usually requires little or no stitches and minimal discomfort.

A second degree tear includes skin and muscle. These tears need to be sutured in layers and can cause discomfort in the postnatal period. However, there are normally no long term effects experienced.

More significant damage of the perineum usually occurs with third degree tears. This perineal trauma involves perineal skin, muscle and extends to the anal sphincter (the muscle that surrounds the anus). This form of perineal damage requires suturing by a doctor and is usually performed in theatre under spinal anaesthesia to ensure correct repair. Post delivery care usually involves physiotherapy and antibiotic cover to guarantee infection does not occur. Long term problems can occur including loss of control when urinating and opening bowels. Follow up with medical professionals is recommended to reduce the number of ill effects.

The most unlikely but serious perineal trauma is known as a fourth degree tear. This tear involves all layers of the perineum and anal tissues. This trauma also requires repair by a doctor in a theatre, usually under spinal anaesthesia. Postnatal care should involve antibiotic cover as well as physiotherapy and follow up with medical professionals as adverse outcomes are likely including urinary and faecal incontinence. Other issues surrounding perineal tears are subsequent pregnancies where method of delivery needs to be discussed. Women with previous fourth degree tears should be encouraged to opt for an elective caesarean section to avoid repeat perineal damage.

Fourth degree tears can occasionally be the result of negligent care. If risk factors have been identified that may suggest that a fourth degree tear is imminent then it maybe required to perform an episiotomy. This a cut that is made to the perineum to increase the space to allow the baby to born quicker and easier and to avoid extensive perineal damage. Unfortunately in some cases, preventative measures are not taken and fourth degree tears do occur.

Many perineal tear claims relate to the negligent repair of a tear resulting in further injury.

If you believe that you have a Birth Injury Claim contact us today to discuss your concerns with a specialist Birth Injury Lawyer.  Our Lawyers have dealt with many claims relating to the development of perineal tears or their negligent repair.