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Perineal Tears Medical Negligence

Perineal Tears Medical Negligence

Suffering a perineal tear during childbirth is not likely to be caused by medical negligence. Tears to the perineum as the baby emerges in a vaginal birth are common and most women receive one to some degree.

However, the medical response to a perineal tear may be negligent and, in our experience, often is.

What's the problem?

There is widespread recognition that, not only are perineal tear rates increasing, but that the medical response to them is sometimes inadequate. Both the Royal College of Obstetricians and Gynaecologists (RCOG) and the National Institute for Health & Care Excellence (NICE) have issued guidelines regarding the management of women during labour. However, severe tears continue to go undiagnosed and women continue to suffer appalling symptoms long after the birth of their child.

Diagnosis

Accurate diagnosis of a perineal tear is absolutely imperative. Without this, the woman may be discharged from hospital with no repair at all and the opportunity for the best timing of restorative surgery will have been lost.

The RCOG recommends that all women who have given birth vaginally should be thoroughly examined immediately after the birth including a digital, rectal examination. Without this procedure it may be impossible to identify a severe tear. A lesser degree of tear may be diagnosed or no tear observed at all.

In these circumstances, where a severe tear has, in fact, occurred, the woman is likely to start to experience leakage of faeces and wind as well as pain and infections in the perineal area. Her severe tear (otherwise referred to as a 3rd or 4th degree tear) has torn the muscle of her anal sphincter and she may have lost the ability to control her bowels.

A midwife or obstetrician who has failed to undertake a thorough examination of a new mother and misses a severe perineal tear is likely to be considered as having behaved negligently towards the mother.

Treatment

A severe tear needs to be repaired promptly, in an operating theatre, by an experienced surgeon. It is not a simple procedure. In the case of a 4th degree tear, the lining of the anal canal as well as the muscle of the perineum and anal sphincter muscles have been torn and it requires skill to achieve a full and effective repair.

The RCOG has issued recommendations with regards to the location, technique, type of practitioner and nature of material to be used in the repair of a severe anal sphincter injury.

Where the guidelines are not followed and an ineffective or incomplete repair is achieved, leaving the woman with on-going symptoms, again the hospital may be considered to have provided a substandard level of care.

In this situation it may be appropriate for the woman to pursue a claim for compensation for her on-going pain and injury. She may be finding it difficult to care for her baby or to work.

Speak to a solicitor

If your severe tear was mishandled, contact Glynns Solicitors to discuss your situation with an experienced medical negligence solicitor. We have supported numerous women to make claims for perineal tear medical negligence and would be happy to advise you.

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

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"Before we contacted you we had no real idea that we had grounds for a medical negligence claim but after speaking to you if became clear that Wendy was indeed treated poorly. Chris took the time to explain what was happening and kept us to speed. Our deepest gratitude to you all and Chris in particular."

"I would like to say a big thank you to you for making this whole process easy and relatively painless. You kept me informed throughout and you were always polite and courteous in all forms of communication. I would not hesitate to recommend you to friends and family, so a really big thank you and I wish you all the best in the future."

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