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First Birth Perineal Injury

First Birth Perineal Injury

Women giving birth vaginally for the first time are at a greater risk than other groups of experiencing a severe perineal injury during the birth. Careful attention is required to assess for any signs of a tear.

Perineal Injuries

Most women will suffer a perineal tear during childbirth. As the baby emerges, the skin and muscle around the vagina comes under pressure to stretch and a tear is a likely outcome.

Women giving birth for the first time, however, are much more likely to experience a severe version of this injury - known as third or fourth degree tears - or obstetric anal sphincter injuries.

Third and fourth degree tears extend from the vagina, through the skin and muscle towards the anus, damaging the muscles which control the opening and closing of the bowels.

It is currently thought that approximately 6% of women giving birth to a single baby at full-term for the first time will experience a severe perineal injury.

In comparison, fewer than 2% of women who have previously given birth, are thought to suffer a severe perineal tear.

Additional Risk Factors

Other factors are also thought to increase the chances of a severe tear occurring such as:

  • Being over 25 years old when having your first child
  • Giving birth to a large baby
  • Having an assisted birth with forceps of ventouse
  • Having Asian origins

If the baby becomes stuck behind the pubic bone (shoulder dystocia) the chance of a severe tear is also increased.

Preventing Perineal Tears

The Royal College of Obstetricians and Gynaecologists has issued guidelines suggesting that the following actions may help to prevent severe tears occurring:

  • Protection of the perineum (area between the vagina and the anus) by the midwife or obstetrician during the birth with one hand whilst the other hand is used to control the delivery of the baby's head
  • Using a warm compress to ease the muscles of the perineum during the birth
  • Perineal massage during the last month of pregnancy and during the birth to help the flexibility of the muscles

There has also been research regarding the best position in which to give birth in order to try to avoid experiencing a tear which suggests that avoiding a squatting position in birth can reduce the chances of suffering a perineal tear.

Examining for Injury

First-time mothers are known to be more likely to suffer a severe tear. Therefore, medical practitioners should be particularly scrupulous about examining the vagina, perineum and anus for any signs of damage.

If a severe tear is not diagnosed, it will not be repaired and this can lead to a life-time of distressing disability for the mother.

Severe tears can cause long-term wind and faecal incontinence, impacting on a woman's ability to work, socialise and care for her family.

Speak to a medical negligence solicitor

If your severe tear was not diagnosed, leaving you struggling with deeply distressing symptoms, you may be entitled to make a claim for compensation. Here at Glynns Solicitors, we have supported numerous women in claims for perineal injury and would be happy to discuss your experience with you.

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

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