A 4th degree tear is the most severe form of obstetric anal sphincter injury which can happen during childbirth. Thankfully, it only occurs occasionally but its long-term effects can be seriously debilitating if it is not effectively repaired at the time of the injury.
4th degree tears
A 4th degree tear causes damage to the skin and muscle of the perineum and extends to injure both the external and internal anal sphincter muscles and the lining of the anal canal. It is most likely to occur where the new mother has required an instrumental delivery or has given birth to a large baby which may have suffered shoulder dystocia.
A prompt and accurate diagnosis of a 4th degree tear, followed by an immediate and highly skilled repair, is vital if the woman is to avoid a lifetime of distressing symptoms such as wind and faecal incontinence.
Failings in the diagnosis and treatment of 4th degree tears
A failure in any of these actions may be regarded as having been negligent in the care of the woman and can be the cause of a claim for compensation.
- A failure to undertake a thorough perineal examination of the new mother including a digital rectal examination may result in a failure to diagnose any anal sphincter damage or a misdiagnosis of the degree of damage experienced. This may result in an inadequate repair or no repair at all.
- A misdiagnosis of a 4th degree tear as a 3rd degree tear will mean that some of the internal damage may not be resolved, possibly leaving the woman with on-going symptoms and the development of a fistula between the bowel and the vagina allowing the leakage of wind and faeces via the vagina instead of the anus
- An incompetent repair may result from the use of inappropriate materials, inaccurate techniques or a failure to achieve a complete repair. This may result in the need for further surgery which is less likely to be as successful
The impact of a 4th degree tear
As well as the appalling physical symptoms which can accompany a misdiagnosed 4th degree tear, the injury can impact on the woman’s ability to maintain a normal life. Working and travelling can become difficult with some careers no longer available due to an element of public interaction.
Socialising can be restricted due to a fear of loss of bowel control and the associated embarrassment.
Psychologically, a 4th degree tear can be destructive to the woman’s confidence and mental health.
Medical negligence
If you are suffering the appalling long-term impact of a misdiagnosed 4th degree tear, contact us to talk to a medical negligence solicitor. It may be appropriate to pursue a claim for compensation.
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If you, or your family member, has suffered a birth injury tear, please call us now for free, no obligation advice on 0800 234 3300 (or from a mobile click to call 01275 334030) or complete our Free Online Enquiry.