Perineal tears are a natural consequence of childbirth. A 3rd degree tear is a type of perineal tear.
Tears during childbirth
If you give birth by way of vaginal delivery, you run the risk of sustaining a perineal tear. This risk is not present during a Caesarean section, although there are of course other risks associated with the procedure.
Anyone can tear during a vaginal delivery, but the risk is higher if it is your first vaginal birth, you need an assisted delivery or your baby is very large. A perineal tear cannot really be predicted or prevented. The exception to this is if you are known to have a very large baby. In such cases it may be advisable to arrange an elective C-section.
An episiotomy will not help you avoid a tear, as was commonly thought in the past.
Grading of perineal tears
Medical practitioners have come up with the way of categorising perineal tears according to the severity of the injury. This ranges from a 1st degree tear to a 4th degree tear, with a 1st degree tear being the most minor and a 4th degree tear being the most extensive.
A 3rd degree tear is defined as an injury that involves the vaginal epithelium, perineal skin, perineal muscle and anal sphincter. A 3rd degree tear is the only type of perineal tear that is further subdivided into a 3a tear, 3b tear or 3c tear.
The different types of 3rd degree tear are defined as follows:
- 3a: partial tear of the external sphincter involving less than 50% thickness;
- 3b: tear of the external sphincter involving more than 50% thickness;
- 3c: external and internal sphincter torn.
3rd degree tear treatment
If you do sustain a 3rd degree tear while giving birth, it should be diagnosed shortly after the delivery during a routine examination. Treatment must then be provided in the form of a surgical repair, normally carried out under local anaesthetic or epidural. The repair must be done by a surgeon, rather than a midwife.
Afterwards you should be given antibiotics and laxatives to take home with you. Antibiotics will help prevent an infection, while laxatives will loosen your stools, ensuring you do not break the stitches by straining to defecate.
Most women make a full recovery from a 3rd degree tear. Some will experience ongoing problems, particularly with regards to controlling flatulence and faecal urgency. However, these complications are much more prevalent amongst women whose 3rd degree tear was mismanaged by medical practitioners.
3rd degree tear claims
If a 3rd degree tear is mismanaged by medical practitioners, there may be grounds for a compensation claim. Contact us for more information.