What is an episiotomy?

An episiotomy is a type of surgical procedure that involves making a cut in the area between the vagina and anus (perineum) during childbirth, effectively enlarging the opening of the vagina to make the delivery process easier.

Episiotomies are typically recommended in situations where the baby needs to be delivered quickly – such as if the child is at risk of not getting enough oxygen – or if it is believed that the mother is at risk of a vaginal tear.

Generally, the procedure is simple to perform, with the surgical incision closed using dissolving stitches after the birth and healing within one month. However, certain risks are involved, particularly if the operation is performed incorrectly or negligently.

What are the different degrees of perineal/episiotomy tears?

If the episiotomy procedure is not performed correctly, it can cause or exacerbate the risk of a painful tear in the perineum, the severity of which can be measured in different degrees:

• First-degree perineal tears are small and skin-deep, usually healing naturally without the need for treatment
• Second-degree perineal tears are deeper and affect the perineal muscles, usually requiring stitches to repair
• Third-degree perineal tears extend to the muscle that controls the anal sphincter, and needs to be repaired surgically as soon as possible
• Fourth-degree perineal tears extend all the way to the lining of the anus or rectum, and also need to be repaired surgically at the earliest opportunity

Although all of these types of tear will usually heal completely over time, they can lead to a number of debilitating side effects, including ongoing pain (especially when using the toilet or during sex), bruising or anal incontinence.

How can medical negligence contribute to episiotomy injuries?

The risk of a mother sustaining an injury after an episiotomy is greatly increased when they receive substandard or negligent care from their obstetrician or midwife. Potential contributing factors include:

• The incision is performed improperly – such as the cut being made straight downwards, instead of diagonally – and this leads to internal damage
• The surgical tools used are not sharp enough
• The procedure was not required or suitable for the patient

If you or a loved one have suffered an episiotomy injury as a result of medical negligence, you should contact a solicitor to enquire about making a claim.