May 2024
The Parliamentary Inquiry into Birth Trauma, published on 13 May 2024, makes deeply troubling reading. Led by the All-Party Parliamentary Group (APPG) on Birth Trauma, the inquiry received more than 1,300 written submissions from women and families across the UK.
Many of the accounts describe serious birth injuries caused by medical errors before, during, and after labour, alongside failures by hospitals to provide explanations or accountability. Most distressing were reports of women being treated without dignity or compassion- left unattended, ignored when asking for help, or dismissed when raising concerns about their own health or that of their baby.
Who Led the Birth Trauma Inquiry?
The inquiry was instigated and chaired by Theo Clarke MP, who also led the first Parliamentary debate on birth trauma. Importantly, Ms Clarke’s involvement highlights that poor maternity care and birth injuries affect women from all backgrounds, regardless of socio-economic status.
Key Findings of the Birth Trauma Inquiry on Birth Injuries
A major focus of the inquiry was perineal tearing, clinically known as Obstetric Anal Sphincter Injuries (OASI).
What Is Perineal Tearing?
Perineal tearing occurs during vaginal childbirth when the tissue between the vagina and anus stretches or tears as the baby is delivered. Tears are classified by severity:
- First degree: Injury to skin only
- Second degree: Skin and muscle damage
- Third degree: Tear extends into the anal sphincter muscle
- Fourth degree: Tear extends into the rectum
The inquiry found that third and fourth degree tears can cause lifelong complications, including bowel incontinence and pelvic organ prolapse.
Professor Mike Keighley, a colorectal surgeon, told the inquiry that many women present decades later with symptoms linked directly to undiagnosed childbirth injuries, stating:
“Incontinence or prolapse had either emerged for the first time or worsened, all due to an injury during childbirth that becomes unmanageable in later life.”
Leading Causes of Severe Perineal Tears
The inquiry identified instrumental (assisted) births as a significant risk factor.
Among the findings:
- 7.5% of first time mothers having instrumental births experience severe tearing
- 1.6% of women having non-instrumental vaginal births after a previous delivery experience severe tearing
- The risk of OASI is 6 times higher with forceps and 3 times higher with Ventouse, when compared to spontaneous vaginal delivery
Other Risk Factors Include:
- Prolonged second stage of labour
- Baby positioned back-to-back
- Baby weighing over 4kg
- Mother aged over 35
- South Asian ethnicity
- Very fast labour
- Shoulder dystocia
- Short maternal stature
Can Perineal Tearing Be Caused by Medical Negligence
Yes. The inquiry confirmed that medical negligence can significantly increase the risk of severe perineal tears.
Examples include:
- Failure to perform an episiotomy when clinically indicated
- Poor monitoring of baby size or position
- Failure to identify or manage shoulder dystocia
- Incorrect or forceful use of forceps or vacuum extraction
- Poor communication or delayed intervention by medical staff
Missed and Misdiagnosed Perineal Tears
The inquiry revealed that perineal tears are frequently missed or misdiagnosed.
- Official figures suggest 3.1% of vaginal births result in tearing
- Evidence cited by the inquiry suggests that the real figure may be closer to 10%
Professor Keighley reported that in 60% of cases involving third or fourth degree tears, the injury was missed at birth.
Misdiagnosis can have devastating consequences. One woman described how:
- Her fourth degree tear was misdiagnosed as second degree
- She later developed bowel incontinence
- Her symptoms were dismissed as psychological
- Over 21 years, she underwent 18 surgeries, ending in a colostomy.
Where a tear is missed or incorrectly repaired, this may amount to medical negligence, giving rise to a birth injury compensation claim.
Making a Birth Injury or OASI Compensation Claim
If a severe perineal tear is missed, misdiagnosed, or caused by negligent maternity care, a woman may be entitled to claim compensation.
Compensation can help cover:
- Ongoing medical treatment and surgery
- Physiotherapy and rehabilitation
- Psychological support
- Loss of earnings
- Long-term care needs
- Pain, suffering, and loss of quality of life
A claim can also provide answers, accountability, and an apology from the NHS Trust involved.
Get Expert Legal Help for Birth Injury Claims
If you or your baby have suffered a birth injury due to negligent care, you are not alone. What matters now is securing the support and compensation needed to fund recovery and future care.
Our birth injury solicitors have decades of combined experience handling complex medical negligence claims. We are:
- Compassionate and understanding
- Clear and honest in our advice
- Committed to achieving the best possible outcome.
Call us on 01625 667166 today to discuss your claim
Free confidential consultation available
We are here to support you every step of the way
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