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World OASI Week 2020 - Raising Awareness of Perineal Birth Injuries

World OASI Week 2020 - Raising Awareness of Perineal Birth Injuries

World OASI Week was launched in 2019 by the support group, Mothers With 4th Degree Tears, to try to bring about increased awareness of these terrible injuries and thereby improve outcomes for new mothers.

What are OASI?

The term OASI refers to obstetric anal sphincter injuries. These are injuries which occur during vaginal childbirth to the muscles around the anus which control bowel movements and the passing of wind. Damage to these muscles can cause extreme urgency when needing to go to the toilet. It can also cause leakage or incontinence of both wind and faeces.

Depending on the extent of the injury, these severe perineal tears should be clearly classified as follows:

  • A 3a tear refers to an injury which affects less than 50% of the thickness of the external sphincter
  • A 3b tear affects more than 50% of the thickness of the external sphincter
  • A 3c tear affects both the external and internal sphincter
  • A 4th degree tear affects both external and internal sphincter muscles as well as the anal mucosa, or lining of the anal canal.

In the above classification, a fourth degree tear is the most severe form of injury, likely to cause the most severe and debilitating symptoms.

Perineal tears are a risk of vaginal childbirth but there is often a reluctance on the part of women who have suffered them to talk about their injuries and the appalling impact they can have on a woman's life and self-confidence.

Diagnosis and care of OASI

Due to the potential life-changing effect of these injuries, it is vital that they are diagnosed accurately following the birth of a baby, and promptly repaired by an experienced surgeon in an operating theatre.

However, 3rd and 4th degree tears are sometimes misdiagnosed. A failure to identify and accurately classify severe perineal tears, leading to a failure to repair the injury, may be regarded as negligent. Should the new mother suffer distressing symptoms as a result, it might be appropriate to make a claim for compensation.

Concern has been expressed by various organisations that midwives require more specific training related to the impact of these injuries and how to ensure a precise diagnosis of any damage.

The Royal College of Obstetricians and Gynaecologists introduced a 'Care Bundle' in 2017 to try to reduce the occurrence and long-term impact of these injuries through greater awareness, and better support, assessment and repair.

In 2019, World OASI Week, with widespread support on social media, considered issues of prevention, care and the emotional and physical impact of severe perineal tears.

This year, World OASI Week is due to take place from 7th to 13th September.

Legal advice

If you or a loved one are struggling with the shocking long-term impact of an unrepaired severe perineal tear, contact Glynns Solicitors. One of our team of specialist medical negligence solicitors will be very happy to talk to you.

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