Definition of birth injuries to mothers

The process of giving birth should be a safe and happy experience – but sometimes things go wrong, or the delivery could have been managed better by clinical staff overseeing a birth. Thankfully serious incidents during birth are rare – but mothers who suffer emotional and physical trauma may be left unable to bond with their babies immediately and fearful of any future pregnancy or birth.

Birth injuries to mothers can involve physical trauma such as tears to the vagina, unnecessary bruising and lack of pain relief. In extreme cases, mothers may suffer adverse incidents such as stroke or even heart attack. Oxygen deprivation during birth can happen but is rare.

However, any physical trauma to a mother giving birth – and especially if urgent medical intervention or surgery is needed – can undermine what should be the happiest and most fulfilling time for a family.

This may cause long-term emotional issues, as well as further need for medical care to rectify problems. Birth injuries to mothers which could have been avoided or which result from a failure in care during pregnancy or delivery are often the subject of medical negligence claims, which can cover both the physical and emotional trauma this can cause.

The sort of physical birth injuries which women may suffer include:

• Perineal tears can occur to the area of skin between the vagina and the anus (the perineum) and are categorised according to four different levels of severity:

• 1st degree perineal tears will not usually cause long-term issues and require suturing to repair the tear and help healing

• 2nd degree perineal tears can spread further and affect muscle tissue

• 3rd/4th degree perineal tears are more severe and usually require immediate treatment, as the tear may extend as far as the anal sphincter.

Sometimes during birth an episiotomy has to be performed to enable the baby’s head or bottom to pass through the vagina. This involves making an incision in the perineum which will then be sutured after delivery.

Perineal tears are more likely to occur with larger babies and forceps deliveries, when invasive treatment takes place to help a mother deliver her baby. 

Some perineal tears occur naturally during childbirth, however, and it is important that mothers receive treatment and support in dealing with any long-term issues resulting from this.

If not treated adequately or fully, complications such as pain, infection, problems passing stools and future problems with resuming sexual relations can occur, causing enormous distress to a new mother and placing pressure on the family unit.

• Nervous shock is an umbrella term for a range of emotional and psychological conditions which can arise if a birth is physically or emotionally traumatic for a mother. Fear, anxiety, postnatal depression, post traumatic stress disorder and being unable to bond with a new baby are just some of the symptoms new mothers can suffer if a birth is not handled properly by health services and medical staff in attendance. Some traumatic situations are unavoidable, however, and may be circumstantial rather than the fault of anyone else. Nervous shock can have long-term implications for the mother and the family unit and should be addressed by GP services.

• Retained products of conception involve situations in which tissues such as the placenta are not expelled during miscarriage or delivery, causing infections, pain, discomfort and sometimes heavy bleeding. Mothers who miscarry at home need to be examined by a doctor to make sure all the tissues related to conception have been expelled by the uterus. Retained products of conception can not only cause physical problems for a woman, but add to the trauma of miscarriage or cause emotional trauma and physical discomfort after giving birth.

• Surgical instruments left inside a new mother after a Caesarean, for example, can lead to pain, infection and bleeding and mean further surgery is necessary to remove them once the problem has been diagnosed. Medical negligence such as leaving a surgical instrument inside a patient can be the subject of personal injury claims for both the physical and emotional issues which arise as a result. Diagnosis can also be difficult to obtain, as this is still a rare occurrence, meaning the patient continues to suffer discomfort unnecessarily and may not be able to work or look after their newborn and family.



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