Perineal tear claim settles for 6-figure sum

Jodi Newton

Successful claim for mother with third-degree perineal tear

Osbornes Law recently settled a birth injury claim for a woman who endured a traumatic labour. Her son suffered a hypoxic brain injury and was transferred to another hospital shortly after birth for cooling therapy. Thankfully, his development progressed well—he is now a happy, active child with no lasting effects from the incident.

While her son made a full recovery, the client sustained a third-degree perineal tear and suffered a significant physical injury, along with ongoing psychiatric trauma. She was examined by an experienced perinatal consultant psychiatrist, whose diagnosis and treatment plan helped her explore therapy options and supported her psychological recovery.

The claim was settled for a six-figure sum. The litigation process proved cathartic for the client, helping her emotionally process the experience. She has since been able to move forward and is now considering a second child—something she had previously ruled out when she first instructed Stephanie Prior.

Supporting families after traumatic childbirth

We are frequently approached by families who have gone through difficult childbirth experiences. This includes cases where:

• A child has suffered a birth injury
• A child has tragically passed away
• The mother has suffered a significant injury, even when the child is healthy

One common maternal injury we see is perineal tearing.

Understanding perineal tears

According to the Royal College of Obstetricians and Gynaecologists, up to 9 in 10 first-time mothers who give birth vaginally will experience some form of perineal trauma—this could be a minor tear, a graze, or an episiotomy.

The perineum is the area between the vagina and the anus. While minor tears are common and heal quickly, severe tears can have long-term effects on a woman’s physical and emotional health.

Risk factors for perineal tearing

Some factors can increase the likelihood of perineal tearing, although many are unavoidable. These include:

• Having a large baby (over 4kg)
• Induced labour
• Use of forceps or ventouse
• Prolonged pushing
• Shoulder dystocia
• Episiotomy

Degrees of perineal tears

There are four classifications of perineal tears:

1st-degree tear

Involves the skin of the perineum and back of the vaginal mucosa. Often small and may heal naturally without stitches.

2nd-degree tear

Involves the skin, vaginal wall, and muscles of the perineum. Requires stitches.

3rd-degree tear

Extends through the vaginal wall and perineal muscles into the anal sphincter. Requires stitches, often under anaesthetic.

4th-degree tear

Similar to a 3rd-degree tear but also involves the rectum. Requires surgical repair in an operating theatre.

When does a perineal tear amount to medical negligence?

A tear itself is not automatically a sign of medical negligence. The key issue is whether:

• The tear was properly diagnosed
• The repair was carried out competently
• The patient received appropriate follow-up care

Repairs of third- or fourth-degree tears require specialist training. Most junior doctors (SHOs) do not have this, so repairs should be carried out or directly supervised by an ST6 or higher doctor in an operating theatre.

Post-tear treatment and care

If you have suffered a third- or fourth-degree tear, you should be given:

• A 5–7 day course of antibiotics
• Adequate pain relief
• Ongoing support and monitoring during recovery

How we can help

If you have been affected by a failure to diagnose or repair a tear during pregnancy, please contact us by:

• Filling in our online enquiry form; or
• Calling us on 020 7485 8811