Do I have a perineal tear injury compensation claim?

A perineal tear is painful split in the skin and muscles between the vagina and the rectum, usually occurring as a consequence of natural childbirth. It is estimated by the Royal College of Obstetricians and Gynaecologists that more than 85% of women who give birth naturally sustain some perineal injury, of which 60-70% will need suturing.

Who is at risk of a perineal tear?

Updated: October 8, 2018

Those most at risk are women giving birth for the first time, especially where the baby is over 8lb 13oz (4kg) or the second stage of labour is very short.

Induced labour or assisted delivery (forceps or ventouse) may also increase the risk of perineal tears.

However, for many women there is no clear reason for the tear.

Can perineal tears be avoided?

If a midwife or other healthcare professional believes a woman to be at risk of tearing her perineum an episiotomy may be performed. This involves making a cut through the vaginal wall and perineum to create more space for the baby to be delivered. Unfortunately, an episiotomy does not always prevent further tearing of the perineal skin, muscles, anal sphincter and anal mucosa, known as third or fourth-degree tears.

Treatment of perineal tears

Third and fourth degree tears require repairing by an experienced doctor who will suture the tear under epidural or spinal anaesthetic. The stitches should be dissolvable and disappear within 6 weeks. Tears that are identified and properly managed should heal well and not present further problems.

What are the complications of perineal tears?

If the wound does not heal properly there is a risk of infection. It may also continue to bleed during physical activity. The wound may be swollen and bruised for some time, affecting urination and defecation.

Stitches which fail to heal may create a risk of a fistula developing, allowing faecal matter to pass from the rectum into the vagina.

Damaged muscles around the perineum may cause severe pain in the area, including pelvic and abdominal aches. This may impact on mother and baby bonding and aggravate post-natal depression.

Sometimes haematomas occur soon after childbirth and if large, may need to be drained.

Can women claim for perineal tears?

Because perineal tears are common, many women believe them to be a necessary part of childbirth and are reluctant to discuss their injuries. However, it is vital that injuries to the perineum are correctly and quickly identified and that midwives and doctors attending deliveries seek expert advice.

Where the treatment of the traumatic tear has been non-existent or inadequate the consequences may continue for years. The misery of chronic pain, incontinence and painful intercourse may also cause psychological damage.

What type of claim can I make?

For a claim to be successful it will be necessary to demonstrate that the injuries sustained were either caused by a health care professional's failure to act or that the treatment was incorrect and caused damage.

Failing to act would include not diagnosing a tear or not taking appropriate measures to prevent a tear. A healthcare professional may be found to be negligent if the wound was poorly stitched or sutured, or if the healing process was not properly monitored.

A woman with a perineal tear should be advised on the necessary aftercare of the wound to help to heal and to prevent infections.

It may be also appropriate for a woman who has sustained a third or fourth-degree perineal tear to be offered a Caesarean section for subsequent pregnancies.

How much compensation can I claim for a perineal tear injury?

The amount of compensation you will receive depends on a number of factors. Our personal injury compensation calculator provides an accurate estimate of your likely compensation.

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About the author

With over 20 years' experience in the law, Jenny has spent the last decade specialising in personal injury, with a particular focus on industrial disease cases.

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