Sunday, September 30, 2012

3rd Degree Tears: Frequently Asked Questions

With around 9% of women experiencing a third degree tear during childbirth, the number of those affected is relatively low. Even so, if you were unfortunate enough to have sustained a third degree tear, it is likely you will have some questions that need answering. This article compiles a list of frequently asked questions regarding third degree tears to help you through this difficult time.

What Is A 3rd Degree Tear?

A third degree tear is an injury sustained during a vaginal delivery, and involves a tear to the perineum that extends to the anal sphincter complex. Third degrees tears can themselves differ in severity, and are classified as follows:-

3rd degree Injury involving the anal sphincter complex.

3a Less than 50% of external anal sphincter torn.

3b More than 50% of external sphincter torn.

3c Internal anal sphincter torn.

How Is A 3rd Degree Tear Treated?

If a third degree tear does occur during childbirth, medical staff should detect the injury either during or after childbirth. All mothers who have given birth vaginally must now have a genital examination after birth to ensure any problems are diagnosed as soon as possible. This, therefore, means that no third degree tears should go untreated.

Once a third degree tear is confirmed a mother should quickly undergo repair. This should be in a well-lit theatre, where a surgeon (not a midwife) should suture the wound together. Post-operatively treatment should continue with:-

* Antibiotics - to prevent infection;

* Laxatives - to help bowel movements;

* Pain relief medication.

In addition to medication, a mother can help a third degree tear heal by maintaining good hygiene, drinking plenty of fluids, eating healthily, and regularly performing pelvic floor exercises.

Can Spotting Happen After A 3rd Degree Tear?

Bleeding after giving birth, known as 'lochia', will be experienced by women after any form of delivery. It usually last for around three weeks, although some may continue to bleed lightly for up to six weeks. After this there is the possibility that spotting will happen. However, if this spotting becomes heavier or continues for an extended amount of time, medical advice should be sought. It is possible that the stitches begin to bleed, and if this is the case immediate attention is necessary as the risk of infection will be increased.

Can I Have Another Vaginal Delivery After A 3rd Degree Tear?

There is no straightforward answer to this question, as each case varies. It is quite common for women to have another vaginal delivery after having had a third degree tear, particularly if the wound has healed well.

Even so, an obstetrician should be consulted before another vaginal delivery is considered. It may be that a caesarean section is more advisable, and will almost certainly be the case if symptoms and complications of a previous third degree tear are still present.

Does A 3rd Degree Tear Amount To Medical Negligence?

A third degree tear in itself does not amount to medical negligence, as it is unfortunately a natural risk of vaginal delivery. It can be difficult for medical staff to predict when a third degree tear is going to happen, but the likelihood is generally considered to increase if:-

* It is a first vaginal birth;

* The baby is larger than average (over 8 pounds 13 ounces);

* Labour is induced or assisted (eg. forceps delivery);

* There is a long second stage of labour;

* The baby's shoulder gets stuck behind the mother's pubic bone.

Where grounds for medical negligence claims often arise, however, is if a third degree tear fails to be detected or is poorly repaired. Both these incidents can cause serious complications for the mother, including anal incontinence, extreme pain and infection.

If you have suffered a third degree tear that was not diagnosed, misdiagnosed, or treated at a sub-standard level of care, you should seek legal advice. You may be able to make a medical negligence claim and get compensation for you suffering.

Copyright (c) 2011 Julie Glynn

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