Perineal tear claims

Perineal tears are injuries to the area between the vagina and the anus (the perineum) that can occur during vaginal childbirth. They are classified by severity:

• First-degree tears involve only the skin of the perineum and the back of the vagina, usually healing quickly without treatment
• Second-degree tears affect both the skin and the perineal muscle, and usually require stitches
• Third-degree tears extend into the muscle surrounding the anus (the anal sphincter) and will require stitches
• Fourth-degree tears are the most severe, extending through the anal sphincter and into the lining of the rectum, requiring stitches
• Periurethral lacerations are tears or injuries to the tissues around the urethra, and treatment depends on severity

Third- and fourth-degree tears are sometimes referred to together as obstetric anal sphincter injuries (OASIs).

Several factors can increase the likelihood of experiencing a tear during childbirth, including:

• First vaginal birth where the perineum is stretched for the first time
• A large baby, typically weighing more than 4 kg (approximately 9 lbs)
• A prolonged second stage of labour (the pushing phase)
• Rapid delivery, where the baby descends quickly, and the perineum does not have time to stretch gradually
• Instrumental delivery using forceps or ventouse
• Shoulder dystocia, where the baby’s shoulder becomes stuck behind the mother’s pubic bone
• Older maternal age, which can be associated with reduced elasticity
• Episiotomy, which is an incision made in the perineum to assist delivery, sometimes leads to more severe tearing

Healthcare providers are expected to identify these risk factors and manage the birth accordingly. Failure to do so may be considered negligent.

Complications vary depending on the severity of the tear and how it is managed. They can include:

• Persistent pain in the perineal area, particularly when sitting or walking
• Infection, including redness, swelling, and discharge
• Significant bleeding
• Urinary incontinence due to damage to the pelvic floor muscles, which may be temporary or long-term
• Bowel incontinence or difficulty controlling bowel movements, particularly with third- and fourth-degree tears
• Pain during sexual intercourse and reduced sexual function or sensation
• Delayed healing or the wound reopening, requiring further medical intervention
• Emotional distress, trauma, depression, and difficulties bonding with your baby

The impact of a severe tear can extend to your relationship with your partner, your ability to return to work, and your overall quality of life.

Medical negligence related to perineal tears can take several forms:

• Failure to diagnose or manage a tear, such as healthcare providers not properly identifying or treating a tear during or after childbirth, leading to worsening complications
• Improper use of instruments, such as a lack of appropriate skill and care in using forceps or ventouse during delivery
• Failure to obtain consent, such as not advising the mother about alternatives like a caesarean section, where that advice should have been given
• Failure to identify risk factors, such as not assessing or acting on known risks like a large baby, previous tears, or prolonged labour
• Delayed or inadequate repair, such as a tear that is not repaired promptly or correctly, which can cause serious long-term harm
• Lack of proper supervision, such as inexperienced or unsupervised staff handling the delivery or repair incorrectly

To have a valid medical negligence claim, we generally need to establish four things:

1. That the healthcare provider owed you a duty of care. In a medical setting, this is usually straightforward.

2. That the provider failed to meet the standard of care that a reasonably competent healthcare professional would have provided in the same circumstances.

3. That the breach of duty directly caused you harm, also known as causation.

4. That you suffered a loss as a result, whether physical, emotional, financial, or a combination.

You do not need to work this out on your own. If you think any of these elements may apply to your situation, please contact us. We will discuss your case and give you an honest assessment of your options.

We will help you gather the evidence needed to support your perineal tear claim. This typically includes:

• Medical records, including prenatal care, labour and delivery notes, and any records of post-birth treatment
• Witness statements from you and anyone else who witnessed the care you received
• Independent expert evidence from medico-legal experts who can provide opinions on whether the standard of care was breached and how that caused your injury
• Complaint correspondence, including any communication with the healthcare provider or complaint responses
• Financial records and documentation of any losses you have incurred, such as medical costs, travel expenses, and lost income

You do not need to have all of this ready before you contact us; gathering evidence is part of what we do.

The amount of compensation you’ll receive depends on several factors, including the severity of your tear, the complications that resulted, and the impact on your daily life, work, and relationships.

Compensation generally covers two areas. General damages reflect your pain, suffering, and loss of amenity: the way your injuries have affected your quality of life. Special damages cover financial losses, including medical expenses, treatment costs, travel, lost earnings, and anticipated future costs such as ongoing care.

Speaking with one of our specialist solicitors will give you a more accurate estimate based on your individual circumstances.

In general, you have three years from the date of your injury, or from the date you became aware of the injury, to make a compensation claim for a perineal tear. However, there are exceptions in certain circumstances.

We encourage you to speak to us as soon as possible to ensure you do not miss any critical deadlines. We can advise on your specific situation and ensure your claim is investigated in good time.

Yes. You can make a perineal tear medical negligence claim on a ‘No Win, No Fee’ basis. This arrangement, also known as a Conditional Fee Agreement (CFA), means you do not pay legal fees upfront and do not carry the financial risk if your claim is unsuccessful.

If your claim succeeds, your opponent pays most of your legal costs. Any unrecovered costs are deducted from an agreed percentage of your settlement, which we will discuss with you in advance.

Other forms of funding may also be available, including legal aid. We will talk through all the options with you when we assess your case.

The time it takes to settle a perineal tear claim varies depending on the complexity of the case and other factors:

• The time needed to gather medical records, expert opinions, and other evidence
• Whether the defendant admits liability or contests the claim
• Whether the case settles through negotiation or proceeds to court

Most claims are settled out of court through negotiation, which can help speed up the process. However, if court proceedings are necessary, it can take several years to conclude. There are still opportunities to settle throughout that process.

Once a settlement is agreed, you can typically expect to receive your compensation within a few weeks. Each case is unique, and one of our specialist solicitors can give you a more accurate timeline based on your situation.