Traumatic birth experience leads to avoidable injury
3rd Feb 2022
Women frequently need legal advice following injuries sustained during a traumatic birth experience. The most common gynaecological injuries are:
- pelvic floor muscle damage;
- pelvic organ prolapse;
- labial/perineal tears; and
- complications following a Caesarean section.
In some cases, even with the best medical care, these injuries are unavoidable. However, there are other situations where the medical and nursing practitioners involved have failed to take reasonable care of a woman in labour, leading to a traumatic birth injury. Examples include failure to:
- identify that an episiotomy was required in a timely manner;
- adequately treat, suture and/or repair a third- or fourth-degree perineal tear;
- appropriately manage and follow up unavoidable injuries leading to an exacerbation of that injury; and
- recognise the risks of vaginal births and recommend a Caesarean section in a timely manner.
At January 2022, Brave Legal was acting on behalf of a woman who gave birth to her first child in 2017 and who continues to suffer from a gynaecological birth-related injury. In 2017 she was admitted to a public hospital and was in labour for approximately 24 hours before giving birth to a healthy baby. Unfortunately, during the second stage of labour, her baby became distressed and the medical staff oscillated between proceeding with an emergency Caesarean section and a forceps delivery. They ultimately conducted an instrumental delivery without an episiotomy – resulting in a third-degree perineal tear.
Following the birth, although it was noted by junior doctors that the plaintiff should be taken to theatre to repair the third-degree perineal tear, the senior gynaecological consultant proceeded to repair the perineal tear in the birthing suite.
After trying to manage her post-surgical condition privately, the plaintiff consulted a number of doctors and was ultimately advised that the repair was inadequate and poorly performed. She continues to suffer from ongoing physical and psychological injuries as a result of her traumatic birth experience.
This situation, although familiar to many women who have given birth, should not continue to happen. In 2015, the Royal College of Obstetricians and Gynaecologists released a third edition of The Management of Third- and Fourth-Degree Perineal Tears. In this guideline, it is clearly stated that repairs of third- and fourth-degree perineal tears ‘should take place in an operating theatre … with good lighting and with appropriate instruments.’
In this case, the decision to repair the third-degree perineal tear in the birthing suite, rather than in an operating theatre, was clearly inconsistent with the guideline. The plaintiff’s injuries were preventable.
As the founder of Brave Legal, Bree Knoester observes, the incidence of birth injuries is increasing:
‘In non-instrumental deliveries, Australian women experience vaginal tears at a rate almost double the OECD average. There appear to be various reasons for this but what we also know is that reporting of tears is increasing and conversations around birth trauma are more frequent. Increased awareness and education, at doctor, nurse and patient level, is critical so that women are adequately informed and supported if a tear occurs. There is no excuse for failing to properly care and assist a woman leaving hospital with a vaginal tear.’
It can be very difficult to share such a private experience and to then take legal action but it is important that women know such injuries are common, they are sometimes preventable, and legal advice should be sought before the time to bring a claim passes.
This is an edited version of an article first published by Brave Legal.
Brave Legal lawyer, Jyoti Haikerwal, is a volunteer with the Australasian Birth Trauma Association, and is currently working with Board members to develop strategies to provide resources, mentoring and advocacy to a wider network of people who have been impacted by a traumatic birth injury.
The views and opinions expressed in this article are the author's and do not necessarily represent the views and opinions of the Australian Lawyers Alliance (ALA).