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Birth Injury Case Studies

Episiotomy Complications

After giving birth to her first child, Shilpa began to notice an unusual leakage from her vagina, and soon realised there was a problem.

When Shilpa went into labour with her first child, she had had an easy pregnancy, and was showing no complications during the first stages of labour. When Shilpa first felt she was ready to start pushing, the midwife prevented her, saying she still had some way to go.

After another hour Shilpa was told she could start pushing, but by this stage she was struggling and felt unable to do so. The midwife took the decision to make an episiotomy, a surgical cut to the perineum that widens the vagina and aids delivery. Shilpa's daughter was born soon after, and the midwife subsequently stitched the episiotomy cut.

Shilpa was discharged three days later, but soon noticed she was leaking faeces from somewhere near her vagina, not her anus. She went to see her GP who said her problem would improve with pelvic floor exercises. As the months passed, however, Shilpa's condition deteriorated. She was leaking more and more often, and was referred to a specialist.

Before this appointment took place, Shilpa went to see a gynaecologist while she was visiting family overseas. There she was told for the first time that her leakage was due to the treatment she received during the birth of her daughter. Shilpa was advised that she had in fact suffered third degree sphincter damage that had failed to be diagnosed, and would need reconstructive surgery.

When she returned to England, Shilpa related this diagnosis to her specialist. It was confirmed that the midwife had not recognised the third degree tear, and thus it had not been repaired according to hospital regulations by a surgeon in a well-lit theatre. The episiotomy had therefore been stitched in such a way that only partly repaired the damage. This left Shilpa with a deficient anterior half of her anal sphincter, while much of the perineal body was lost. Additionally, she suffered a recto-vagina fistula, which meant she leaked faeces through her vagina.

Shilpa later underwent surgery, but continued to suffer the on-going effects of her injuries, which she found distressing, for a further two years.

After contacting Glynns, we instructed a midwifery expert to prepare a report on Shilpa's case. It was found that not only was the episiotomy Shilpa received unnecessary, but it was performed in a way that fell below acceptable standards. Furthermore, the midwife failed to examine Shilpa properly after delivery, meaning her third degree tear was not recognised or referred to an experienced obstetrician for repair. We helped Shilpa file a medical negligence claim, which was settled for over £60,000.

(Details which might identify our client have been changed.)

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