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4th Degree Tears in Childbirth

4th Degree Tears in Childbirth

Only a small fraction of women experience a 4th degree tear but they are devastating in their impact. What are they?

What is a 4th degree tear?

A 4th degree tear is the most severe form of tear that a woman can experience during the process of giving birth vaginally.

A 4th degree tear injures the skin and muscle from the vagina, across the perineum to the anus where it also tears the sphincter muscles around the anus as well as the internal lining of the anal canal.

It is a significant injury which, thankfully, only occurs to a small percentage of new mothers.

What causes a 4th degree tear?

A 4th degree tear is most likely to occur with a first-time mother or to someone who has experienced a severe perineal tear previously and has chosen to give birth vaginally again.

It occurs when the baby emerges from the vagina stretching the surrounding tissue and skin. It is therefore more likely to occur when the baby is large.

It is also more likely to occur if forceps or a ventouse have been necessary to help the mother give birth.

What are the effects of a 4th degree tear?

If a woman is diagnosed with a 4th degree tear, the first effect should be the need for the woman to undergo surgery to repair the wound in an operating theatre. This is a serious injury and requires a skilled and experienced surgeon to try to ensure that the wound is repaired fully and in accordance with the guidelines of the Royal College of Obstetricians and Gynaecologists.

If the tear is not accurately diagnosed or the repair is inadequate the new mother can go on to experience a range of extremely unpleasant and distressing long-term symptoms:

  • if the anal sphincter cannot function properly, the woman may lose the ability to control wind and may find that she releases wind involuntarily
  • it may also mean that she is unable to control the release of faeces and she may experience significant urgency when needing to go to the toilet
  • if the internal tissue of the anus breaks down due to a poor repair, a fistula may develop between the bowel and vagina meaning that faeces leak from the vagina
  • the woman may require further surgery which can sometimes involve the need for a colostomy - temporary or permanent - to provide an alternative route for faeces to exit the body other than through the anus.

Medical Negligence

A perineal tear is a natural occurrence and it may not be possible to prevent one occurring. However, it should be possible to ensure that the mother receives expert care once it has occurred.

If you continue to suffer the appalling symptoms of a 4th degree tear because of a failure to diagnose or repair adequately, contact Glynns Solicitors. We will be able to give you independent expert advice.

You may be able to make a claim for compensation for the pain and injuries you have suffered.

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

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