Copyright (c) 2010 Julie Glynn

With over 500,000 natural child birth's per year, it is perhaps not surprising that a large number of women suffer perineal tears during the child birth process. Of the 500,000 births approximately 50 to 60% of the women will need stitches, but more worryingly 2% will suffer tearing that reaches the anus. That is over 10,000 women year experience perineal tears that require anal suturing.

The Potential Complications From A Perineal Tear

The major complications from a perineal tear can include:

* General pain and discomfort.

* Painful sexual intercourse, known as 'Dyspareunia'.

* Anal incontinence.

* Social problems.

* Psychological issues arising from the problems above

The extent of the tear will determine how many problems a mother is likely to have after the birth. Tears are classified in the following way based on their severity:

* First degree perineal tear: injury to the skin only.

* Second degree perineal tear: Injury to the perineum including the perineal muscles but not including injury to the anal sphincter.

* Third degree perineal tear: As above but also including injury to the anal sphincter.

* Fourth degree tear: As above but the tear also goes deeper into the anus causing tearing to the anal epithelium.

Repairs to Perineal Tears.

Repairs to first and second degree tears are usually carried out by the midwives and will include suturing under local anaesthetic with a thorough examination to ensure that the stitching does not go into the rectum.

Repairs to third and fourth degree tears are more complex. Repairs should be carried out by obstetricians or colorectal surgeons as the stitching is more complex. The repairs will be carried out under local or general anaesthetic and should usually be carried out as soon as possible after the birth.

After the stitching has been applied the treatment will continue with antibiotics to reduce the chances of infection, along with laxatives to prevent damage to the repair.

Once the patient is mobile and able, pelvic floor muscle exercises will be advised. If problems persist (such as anal incontinence) there is likely to be a referral to a colorectal surgeon. Prognosis

Fortunately, 60 to 80% of patients will have no symptoms after 12 months. The remaining patients will have ongoing symptoms of varying degrees. When Might A Perineal Tear Lead To A Medical Negligence Claim?

There are several reasons that might allow you to make a claim for compensation as a result of a perineal tear. These can include:

* Failue to recognise the increased risks of a tear or to take any preventative action.

* Failure to recognise and treat any damage to the anal sphincter.

* Failure to identify the tissues accurately during treatment.

* Faiure to carry out any repair to the damaged area.

* An untrained person carrying out the repair.

* No anaesthetic provided.

* Failure to remove a swab or other treatment item from the damaged area.

* Use of the wrong items for the repair leading to a breakdown of the repair requiring further treatment.

* Failure to arrange follow up and to act on the symptoms.

Your Choices?

If you have suffered a perineal tear during childbirth and have any of the above applies to you, you should urgently seek advice from a medical negligence specialist. They will be able to explain your options to you so that you can decide if you would like to pursue the matter further. Many will be able to help you under a Medical Negligence No Win No Fee agreement saving you the costs of pursuing the claim and providing you with an insurance policy to take away the risk of having the pay any costs to the National Health Service Litigation Authority.