Case study: Traumatic birth experience leads to avoidable injury

At Brave Legal, we frequently provide advice to women following injuries sustained during a traumatic birth experience.

The most common gynaecological injuries are:

• pelvic floor muscle damage;
• pelvic organ prolapse;
• labial/perineal tears;
• complications following a Caesarean section.

We recognise that in some cases these injuries, even with the best medical care, 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 of cases we have been involved in include failures 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 fail to recommend a Caesarean section in a timely manner.

Case study

We currently act on behalf of a mother who gave birth to her first child in 2017 and who continues to suffer from a gynaecological birth related injury. Our client was admitted to a public hospital and was in labor for approximately 24 hours before giving birth to a healthy baby.

Unfortunately, during the second stage of labour, our client was poorly managed. 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 our client sustaining a third-degree perineal tear.

Following the birth, although it was noted by junior doctors that our client 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, our client consulted a number of doctors and was ultimately advised the repair was inadequate and poorly performed.

Our client 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 Gynecologists released a third edition of The Management of Third- and Fourth-Degree Perineal Tears guideline. 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 our 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.

Our client’s injuries were preventable. Our lawyers at Brave Legal have the expertise and experience in assisting many women who have suffered from birth-related injuries. 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 it is important to obtain legal advice before the time to bring a claim passes.

Principal Lawyer and Founder, Bree Knoester, has brought many successful cases for women suffering from birth injuries and observes that the incidence of injuries is increasing. 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.