Episiotomy injuries and incontinence – Sarah’s story

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5 minute read

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Giving birth is both a scary and wonderful time for any mother, and no one expects that everything will go perfectly according to plan. It’s a complex experience and if not managed correctly there are a lot of potentially serious issues that can arise. If things do go wrong, it’s important to make sure that the people providing your medical care are aware that you need help. Unfortunately, when that message doesn’t get through, the result can be life-changing, as one of our clients found out.

What is an episiotomy?

Sometimes a doctor or midwife may need to make a cut in the area between the vagina and the perineum (anus) during giving birth to create space for the baby to come out more easily. This procedure is called an episiotomy and if a clinician needs to perform it, they should first speak to the mum, explain the risks and get permission to do it. The same area can sometimes tear during delivery, especially if the baby is big or the birth is difficult. This is called a “perineal tear”, and will often need surgery to repair it.

Sarah’s perineal tear

Sarah had a difficult delivery with her third child, and after the birth she was told that a very small tear had happened naturally and did not need to be stitched. This baby was much bigger than her first two and had become stuck during delivery.

Following giving birth she felt that things were not right. She could quickly tell that her experience this time was different to the one she had with her first two children. When she continued feeling discomfort in her perineum she sought medical advice and was given antibiotics as her tear had become infected.

Unfortunately, instead of the symptoms gradually going away Sarah realised that she could no longer control her tummy when breaking wind. If she did not rush to the toilet to empty her bowels, she could have accidents. Sometimes she would break wind, only to find that she had emptied her bowel at the same time. She felt mortified.

Not knowing how to manage this and feeling embarrassed to talk to her partner and family about it, Sarah tried to hide her symptoms from them. That significantly affected her relationship with her partner as she was too scared to have sex with him in case her bowels leaked.

Struggling with incontinence after childbirth

These feelings also meant that she could not be the mum she wanted to be to her young family. She avoided family activities like swimming because she was worried about being incontinent, and she became very anxious about going out in case she had an unexpected leak. She was understandably upset at the impact this had on her family.

Sarah’s life outside of the family home was also significantly affected. To try to deal with her new symptoms she developed coping strategies, such as making sure she went to the toilet before leaving the house, watching what she ate and checking where public toilets were before going out.

She was also unable to return to her previous job because she did not have easy access to a toilet and feared being incontinent in front of colleagues and clients.

Investigating Sarah’s claim for incontinence compensation

After an operation to repair the tear did not work Sarah decided to seek legal advice and came to us. We investigated the case and our independent experts advised that the tear during childbirth was much more serious than the midwife had realised. In fact, the midwife had not properly examined Sarah after the baby was born. If she had done so, she would have realised that the tear was not just a small graze to the skin, but extended into the anal sphincter muscles, which give control over emptying the bowel. That was the reason she had the life-changing symptoms, and if that tear had been spotted at the time of the birth, then it would have been repaired immediately and Sarah would not have had any problems with continence.

The hospital involved denied any fault at first, but eventually admitted that they were wrong not to fully investigate the tear and agreed to pay over £150,000 in compensation.

Even though no amount of money could replace Sarah’s quality of life, the compensation she was awarded has paid for a nerve stimulator to be implanted to help with her bowel control and improve her quality of life. Sarah’s compensation will also allow her and her partner to access couples therapy and be able to connect sexually again and fund Sarah to access therapy for herself to find her lost confidence and help her adapt to her newfound symptoms. The claim also took account for lost earnings, which took the pressure off the family finances and allowed them to move forwards after a difficult time.

Even though Sarah’s daily life can’t be as simple as it was before the tear, she is better equipped to cope with her day now she can afford to access support from relevant professionals.

Six percent of first-time mothers are injured during childbirth

Unfortunately, Sarah’s story is not uncommon. On average, 6% of first-time mothers suffer from an obstetric anal sphincter injury like Sarah’s. That means for every 1000 women there are 60 that have experienced this kind of injury, but it’s not commonly known because of the stigma and embarrassment linked to the symptoms. In a society where most women still feel uncomfortable to say they have their period in public, admitting that you have suffered an injury that can make you incontinent is much less likely to be talked about.

Injuries such as these can have a really negative impact for a new mum and in some cases can even prevent her from being able to emotionally connect with her new-born child. Our work means we speak to many mums that have had a similar experience to Sarah, so we wanted to build a relationship with an organisation that can provide them with the emotional and practical advice they need after such an injury.

Help for mothers with continence injuries

MASIC is the only UK charity focusing in providing support to women who have suffered obstetric anal sphincter injuries during childbirth. The charity itself is run by injured women and healthcare professionals that have experience in supporting mums and fighting the stigma associated with such injuries to drive change. By introducing mums that have had a similar experience to each other, MASIC help them to feel part of a community and to normalise their trauma. The charity also reviews products and services which can make life easier for women with birth-related injuries.

Chloe Oliver, CEO of the Masic Foundation, had this to say:

“We thank Enable Law for highlighting this issue and Sarah for her bravery in speaking out and sharing her story, sadly stories like Sarah’s are all too common with OASI injury alone estimated to affect 1 in 50 women in the UK, many of whom suffer in silence struggling with the long lasting mental and physical impact that their injury has on their lives. We are here to help women like Sarah – please don’t suffer in silence but reach out to us at the Masic Foundation, we have lots of information and resources and an amazing network of health care professionals and injured women who can offer support and advice.” Chloe Oliver, Masic Foundation, CEO

If you have suffered an injury like Sarah’s and would like to speak to someone from Masic you can find more information about them as well as contact details here https://masic.org.uk/

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