Pregnant women in England are at ‘increased risk’ of serious injury during birth | birth
Pregnant women in England are at increased risk of serious injury during childbirth, NHS figures have revealed.
the Number of mothers with third or fourth degree perineal tears While the birth rate rose from 25 per 1,000 in June 2020 to 29 per 1,000 in June this year – an increase of 16%.
Such injuries can have a “life-altering” impact on a woman’s physical and mental health, cause post-traumatic stress disorder and make her afraid of having another child.
Obstetric experts have linked the rise in the most serious forms of lacerations to poor NHS care, a shortage of staff in NHS maternity units, and the older age and larger size of mothers.
Women are also at risk because hospitals do not always correctly determine the risk of rupture using the assessment method recommended by obstetricians, midwives and MPs.
Helen Morgan, the Lib Dem health spokeswoman, who obtained the NHS England figures from the House of Commons library, said: “Behind these figures are heartbreaking stories of women suffering unimaginable trauma at a moment that should be full of joy.”
“The Conservatives’ neglect of maternity services is inexcusable, putting mothers and babies at risk. But Labor risks pushing action on this issue into the tall grass.”
The figures mean that nearly 3% of all women born in England suffer a serious rupture. Such injuries damage a woman’s anal sphincter and cause long-term pain, birth trauma, and urinary incontinence.
The revelation of the rise comes after significant concern about the poor quality of maternity care in the NHS prompted Health Secretary Wes Streeting to launch an inquiry into maternity and newborn care and set up a task force to recommend improvements.
Misidentification and treatment of third and fourth degree tears are among the mistakes made by NHS staff that help explain why mistakes in maternity care cost the service more than £1 billion a year.
For example, Sussex University Hospitals NHS Trust in August He agreed to pay £500,000 in compensation A woman has suffered lifelong damage after her fourth-degree tear was wrongly diagnosed as a second-degree tear when she gave birth at the Princess Royal Hospital in Haywards Heath in August 2021.
This misdiagnosis meant that the unnamed woman developed a rectovaginal fistula and was left with toileting difficulties, sexual dysfunction and PTSD, which affected her relationships with her child, family and friends, and meant she was unable to return to full-time work.
Third and fourth degree tears are known in the NHS as ‘obstetric anal sphincter injuries’ (OASI) because they involve the perineum and anal sphincter, or also in the rectum in the case of fourth degree tears.
Chloe Oliver, chief executive of the charity Mothers with Anal Sphincter Injuries during Childbirth, said: “OASIs are more common with the long second stage of labour, in first-time mums. [when] The baby is delivered from back to back, with forceps, if the baby’s birth weight is more than 4 kg and if the mother is of Asian origin.
Ruptures are also more likely when doctors use forceps or a suction device to help remove the baby.
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Oliver added: “OASIs are life-changing and can have a devastating impact on quality of life. Symptoms can include: pelvic pain, difficulty controlling urine, stool and flatus, problems bonding and establishing breastfeeding, psychosexual dysfunction, breakdown in relationships or career, and mental health problems, including postpartum depression, anxiety, PTSD and phobias. Secondary tokophobia, fear of another pregnancy and childbirth.”
The recent National Audit of Maternity and Perinatal report found just that 3.29% of women Women who gave birth vaginally in England, Scotland and Wales in 2023 had a third or fourth degree perineal tear.
Dr Rani Thakkar, president of the Royal College of Obstetricians and Gynecologists (RCOG), said: “For most women, tears are relatively minor and heal quickly. However, if a woman has a deeper tear, known as a third or fourth degree tear, this will have to be repaired in the operating room and her recovery will take longer.”
She added that all maternity units should use the ‘OASI Care Package’ which the RCOG helped design in order to assess a mother’s risk of rupture. But experts say this doesn’t always happen.
A Department of Health and Social Care spokesperson said: “Giving birth can be an amazing moment in a woman’s life, but suffering injuries, including perineal tears, can leave mothers deeply traumatised.
“This government inherited a failed maternity care system, which is why we have rapidly opened a national maternity inquiry, established a national task force and continue to provide perinatal pelvic health services to reduce rates of perineal tears.”