Instrumental births, perineal tears and pelvic organ prolapse

Instrumental births, perineal tears and pelvic organ prolapse

There is frequently an association between perineal tearing and instrumental deliveries.  An instrumental delivery will involve the use of forceps or a ventouse.  

In a forceps delivery, a tool which looks like a pair of salad servers, will be placed on either side of the baby’s head in an attempt to guide the baby out of the birth canal.  It can become necessary to use forceps where the birth is not progressing or where it is imperative to get the baby out quickly.

In a Ventouse or vacuum delivery, a small device is placed on the baby’s head and it can be used to help the mother to push the baby out.

Many women fear the thought of an episiotomy prior to going into labour.  An episiotomy can be used in conjunction with an instrumental birth to control and divert any tearing away from the perineal area.  

What are the four main types of perineal or vaginal tears suffered by women in childbirth?

First Degree Vaginal Tear

This type of tear only involves the perineal skin.  Stitches may be required and there may be some mild stinging when urinating.  This type of tear is likely to completely heal within a few weeks.

Second Degree Vaginal Tear

This type of tear also included the perineal muscle as well as the perineal skin.  A mother suffering from this type of tear will need stitches and the wound will heal in a few weeks.

Third Degree Vaginal Tear

This type of tear also involves the anal sphincter muscle.  A mother suffering from this type of tear should undergo a surgical repair preferably with a colorectal surgeon.  There can be ongoing complications with this type of tear that can lead to faecal incontinence.  This group of mothers will frequently seek legal advice about whether their tear could have been avoided with different obstetric treatment.  

Fourth Degree Vaginal Tear

This type of tear involves the anal sphincter muscle and the rectum.  A mother suffering from this type of tear should undergo a surgical repair preferably with a colorectal surgeon.  There can be ongoing complications with this type of tear that can lead to faecal incontinence.  This group of mothers will frequently seek legal advice about whether their tear could have been avoided with different obstetric treatment as life with this level of tearing can be very challenging.

Is pelvic organ prolapse associated with instrumental deliveries?

Instrumental deliveries can lead to damage to the pelvic floor and pelvic organ prolapse.  Pelvic floor damage and pelvic organ prolapse can cause long term problems for women and can result in urinary incontinence, urinary retention, frequent urinary tract infections, faecal incontinence, painful sex, chronic pain and the requirement for further surgical interventions.

Is levator ani avulsion linked with instrumental deliveries?

Levator ani avulsion injuries can cause the lavator ani muscles to become strained or even detach from the pubic symphysis.  Levator ani avulsion injuries are linked with pelvic organ prolapse, sexual dysfunction, urinary incontinence, faecal incontinence, chronic pain and the need for further surgical intervention.

What are the legal options in relation to injuries caused by an instrumental delivery?

A woman who has suffered an injury following an instrumental delivery may be entitled to compensation for the consequences that flow from that injury if she is able to prove that the injury arose because the hospital or the obstetrician breached their duty of care.  It is important to note that not all injuries following an instrumental birth will be caused by a breach of the duty of care.  Some examples where it may be possible to show that the duty of care was breached are as follows:

  • The failure to perform an episiotomy prior to using forceps to the direct the tear away from the anal sprinter muscle and the rectum.
  • The failure to recommend caesarean section to a woman who is carrying a large baby in comparison to her size.
  • Using forceps when a Ventouse or suction cup was also a viable option.
  • Incorrect placement of the forceps resulting in baby’s head rotating to cover a bigger surface area when the baby is pulled through the birth canal which heightens the risk from trauma.

Where it can be proved that a failure on the part of the hospital and / or the obstetrician caused or contributed to injuries suffered by the mother and or the baby it may be possible to make a claim for compensation for the injuries suffered.

What can be claimed?

Financial compensation can be claimed for: pain and suffering, past and future treatment expenses, past and future wage losses, past and future domestic assistance together with legal costs and disbursements.

Time limits

There are time limits which apply to personal injury claims.  You should seek legal advice promptly if you have suffered injuries in relation to a cosmetic procedure to ensure that you can access all the compensation to which you are entitled to claim.

Legal Costs

At Remedy Law Group we work on a no win no fees basis, which means that you will only be required to pay our legal costs if we achieve a successful outcome for you and our first consultation is always free.