A wrongly sited episiotomy and prolonged second stage of labour caused Lara* lifetime faecal incontinence issues, for which the trust responsible denied liability.
Background
Lara was a first-time mother who had an uneventful pregnancy. She arrived at hospital and was found to be in established labour. She then got to a point where her labour was not progressing as expected, and was given oxytocin to augment labour.
Prolonged second stage of labour
When the cervix becomes fully dilated, it is common practice to allow at least an hour for the baby to descend passively down the birth canal before the mother starts active pushing. Due to an error by the medical and midwifery staff, Lara was left in the second stage of labour for six hours before starting to actively push. She was unable to push the baby out and it was decided to use forceps.
The episiotomy and initial outcome
An episiotomy was carried out to facilitate delivery. Once her baby was born, her perineum was examined and sutured. She was discharged having been told everything had gone well.
Post delivery complications
A few days later, Lara noticed she had no control over passing urine, followed by a lack of control over passing wind and stool. This persisted for weeks before she was referred to a colorectal clinic. Tests confirmed a defect in her anal sphincter area. Despite undergoing therapies, her faecal urgency and inability to control flatus persisted.
Seeking legal support
At this point, Lara contacted Tees for legal support. She filed a formal complaint with the NHS Trust, which responded with an apology, acknowledging the episiotomy had been wrongly sited. Experts were instructed, and a Letter of Claim was sent to the Defendant NHS Trust.
Expert insight
Gwyneth Munjoma, Medical Negligence Senior Associate with Tees, said: “If injury to the anal sphincter is not recognised and appropriately repaired immediately following delivery,repair at a later date is rarely curative. The result is that the woman has to live with an injury which physically impacts on her womanhood, family life, social life and employment. In addition, these women’s entire lives are psychologically affected by the injury of such a sensitive and intimate part of the body.”
Legal challenges and resolution
Despite the letter of apology, the Defendant NHS Trust initially denied liability, further impacting Lara’s psychological well-being. However, the Trust later made a settlement offer. Following negotiations, a six-figure settlement was reached, successfully concluding the case.
Client-centred approach
Reflecting on the case, Gwyneth Munjoma stated:
“As well as my legal training, I have a background in midwifery. With that knowledge, I am able to effectively partner the client bringing in a great deal of knowledge, empathy and understanding throughout the journey of her claim.”
*Names have been changed to protect the privacy of our clients.
