Do Women Really Know the Risks of Vaginal Birth Injuries?

When most people hear the term birth injuries, they immediately think about injuries suffered by the child, but what about the injuries suffered by women? Do women really know the risks of vaginal birth injuries? Are doctors giving women enough information to make informed decisions about their childbirth experience and what to expect after?

A Senate inquiry is looking to address these, and other, questions related to complications of vaginal birth, as well as procedures done to correct them.  There is concern that doctors are failing to address the real risks of vaginal birth because they are worried that women will become too scared about the process.

Risks of Vaginal Birth Injuries

Childbirth is an extremely taxing process, and can quickly become complicated or result in birth injuries.  For the mother, common vaginal birth injuries include:

  • Vaginal Prolapse: Vaginal prolapse occurs when the internal structures (ligaments, muscles, tissue) supporting the uterus, bladder, rectum, and small bowel fall out of place. Weakened or failing structures can result in these body parts resting against the vagina, or in severe cases, even passing through the vaginal opening.  Vaginal prolapse can cause pain, incontinence, and compromised sexual function.
  • Chronic Pain: Many women suffer from chronic pain in the months or even years after childbirth. The reasons for chronic pain vary, ranging from nerve damage to scar tissue, fractured pelvic bones to severely damaged internal structures.  Chronic pain after childbirth should not be ignored, and may be a sign of a serious vaginal birth injury.
  • Scarring: During childbirth, if the baby appears to be stuck, or labor is delayed, the doctor may need to perform an episiotomy, which is a small cut along the vagina. An episiotomy can result in scarring that affects sexual function, or may also injure other nearby structures.
  • Tearing: Vaginal tears are, unfortunately, a common risk of vaginal birth. Most common among first-time mothers (95 percent chance of suffering a tear), vaginal tears are classified in four “degrees”, which are:
    • First-Degree: Small tears involving only the skin around the vagina or perinea. First-degree tears generally heal on their own.
    • Second-Degree: Tears involving the perineal muscles, located between the vagina and anus.
    • Third-Degree: Tears involving the perineal muscles and the muscles around the anus. These tears often require surgery to correct.
    • Fourth-Degree: The most severe, these tears involve the perineal muscles, the anal sphincter, and tissue surrounding the rectum. This degree of injury requires surgical intervention and can take months to completely resolve.
  • Fistula: Similar to a severe tear, a fistula is an injury occurring during lengthy or prolonged childbirth. A fistula occurs when the soft tissue between the mother’s pelvis and the baby’s head is compromised and dies, leaving a hole between the bladder and rectum.  The result is urine and feces leaking from the hole into other organs and the vagina.  Women suffering a fistula injury experience incontinence, foul odor, pain, and complications like kidney disease and other chronic illnesses.

The risk of these (or other) injuries is exacerbated when assistive tools are used for delivery, such as forceps or vacuums.

If you have questions about vaginal birth injuries or other birth injuries you or your child may have suffered, contact Brown & Brothers to get answers.

Managing Complications After Vaginal Birth

Managing complications after vaginal birth can be embarrassing and difficult to deal with.  Nonetheless, it is important that doctors open dialogue with women about the risks and how any complications will be managed.  Vaginal birth is considered, largely, to be the golden standard for childbirth.  It is not, however, always the safest or most suitable option.

Treatment options for vaginal birth injuries varies, with many doctors recommending vaginal mesh surgery to treat complications like prolapse of the vagina or pelvic organs, or incontinence.  Unfortunately, sometimes the treatment itself is not without its own risks.  For many years, vaginal mesh, or transvaginal mesh, has been the subject of much criticism and debate in the legal and healthcare communities.

In 2011, the U.S.  Food and Drug Administration (FDA) reported common problems related to mesh implanted to treat pelvic organ prolapse (POP), which included:

  • Generalized pain; pain during intercourse
  • Infections surrounding mesh
  • Urinary tract problems
  • Erosion of soft tissues around mesh
  • Protrusion of the mesh through soft tissues
  • Damage to nearby organs

Since that time, a number of lawsuits have been filed and the FDA has worked diligently to enhance requirements and regulations for vaginal mesh products.  It is estimated that more than 100,000 individual lawsuits have been filed alleging injuries caused by vaginal mesh surgical implantation.

Sorting Through Complications and Confusion

Childbirth is an incredible experience, but unfortunately, it is also very unpredictable.  Vaginal birth injuries can certainly occur as a result of the natural birth process and may be unavoidable.  Unfortunately, there are also many cases where these injuries are caused by the negligence of a healthcare provider who fails to recognize or act on a complicated childbirth situation.

If you have questions about birth injuries, medical malpractice, or medical device lawsuits, contact Brown & Brothers.  Fill out our online form to speak with one of our skilled medical malpractice and birth injury attorneys.

 

 

Sources:

https://www.healthline.com/health/pregnancy/cervical-vaginal-tears#overview1

https://www.theguardian.com/commentisfree/2017/sep/27/women-have-the-right-to-know-about-injuries-of-vaginal-birth-beforehand

What Is Fistula?

https://www.emedicinehealth.com/vaginal_prolapse/article_em.htm

https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm479732.htm