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What Causes Perineal Tears?

What Causes Perineal Tears?

Perineal tears are common with approximately nine out of every ten women experiencing them during childbirth. But why do they happen and what can be done about them?

What are perineal tears?

Perineal tears are injuries that occur during vaginal childbirth, causing damage to the skin and muscle between the vagina and the anus and sometimes also affecting the anus itself.

They occur as the baby emerges via the vagina because the area around the vagina needs to stretch to allow the baby to be born.

Most perineal tears are small but, occasionally, a mother will experience a severe tear. Severe tears are classified as either 'third degree tears' or 'fourth degree tears' depending on the extent and location of the injury.

A third degree tear will cut the skin and muscle between the vagina and the anus as well as damaging the anal sphincter which controls the opening and closing of the bowel. It may just damage the external anal muscle or it may affect the internal muscle as well.

A fourth degree tear, in addition to the damage caused by a third degree tear, will cause injury to the lining of the anal canal inside the bowel. This is the most severe form of perineal tear.

Why do some women get severe tears?

It is important to be aware that only a few women experience severe tears which require surgical repair.

Studies have suggested that there may be a number of factors that increase the chances of a woman experiencing a severe tear when her child is born:

  • Giving birth to a large baby
  • Giving birth via the vagina for the first time (although the chance of suffering a severe tear increases if you have already received a tear during a previous birth)
  • A prolonged second stage of labour
  • An assisted birth where the baby has been born with the use of a ventouse or forceps
  • If the baby becomes stuck behind the pubic bone (this is known as shoulder dystocia)
  • There is also some evidence to suggest that if the mother is given a surgical episiotomy to ease the passage of the baby, she is more likely to experience a severe tear

Avoiding Perineal Tears

The likelihood of experiencing a perineal tear may be reduced by trying to improve the flexibility of the perineum before the birth through massage and pelvic floor exercises.

There is also evidence to suggest that some birthing positions are more likely to contribute to the occurrence of a perineal tear than others.

Repairing Perineal Tears

Perineal tears are, however, a regular occurrence and it should be routine practice for a midwife or obstetrician to examine the mother thoroughly to ensure that any tear is identified and diagnosed accurately in order to ensure a full repair.

Medical Negligence

If a severe tear is not diagnosed and repaired fully and accurately at the time of the birth, the mother can go on to suffer appalling and life-changing long-term symptoms. If this sounds familiar, contact Glynns Solicitors to discuss your experience. We regularly support compensation claims for severe perineal tears and would be very happy to talk to you.

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