Birth injury to mother Archives

Raising awareness of childbirth trauma

Posted on 24 March 20251 April 2025 by Sarah O'Sullivan

Bringing a child into the world should be a joyful time for mothers and their families, but sadly childbirth is not always such a positive and life-affirming experience.

Birth Trauma Awareness Week (14th – 20th July 2025), an initiative from The Birth Trauma Association (BTA), highlights the issues faced by mothers who have suffered a traumatic birth.

A difficult birth can be a traumatising event for new mothers. It can effect mental and physical health, and a mother’s ability to bond with her baby. Sadly, it’s all too common for women to experience birth trauma. One woman’s account of her traumatic birth experience was recently shared over 90,000 times on social media – with many more similar stories on the web.

How we can help

Many mothers suffering from postnatal PTSD are unaware that they may be able to make a claim for negligent treatment received during childbirth. We have a strong track-record of helping women who have experienced birth trauma. We can help them get answers about what went wrong, as well as financial compensation. We’ll talk through with you what happened in your case, and offer you the advice you need.

Call our Medical Negligence experts on 0800 015 1165, for a free, confidential, no obligation chat, or fill out our online enquiry form and we’ll let you know how we can help.

What is birth trauma?

Trauma can result from a range of events experienced during childbirth and postnatal care. They include:

Poor or negligent treatment by staff
Inadequate pain relief
High levels of medical intervention
Emergency deliveries
Unplanned caesarean sections or other medical procedures
Loss of dignity and control
Stillbirth or birth of a damaged baby (a disability resulting from birth trauma).

Mothers can also experience trauma through feeling that their concerns were not listened to, acted upon, or taken seriously.

According to research from the BTA, up to 20,000 women a year have a traumatic birth experience. Many go on to suffer long-lasting impacts on both their physical and mental health. And it’s not just the mothers involved who suffer: partners can also experience post-traumatic stress disorder after witnessing a traumatic birth. Clearly, this can be a major problem for families, and one that currently doesn’t always receive the attention and resources it needs.

One of the reasons many mothers suffer in silence is that they feel they have no right to feel traumatised if they leave hospital with a healthy baby. Often, women who do come forward are misdiagnosed or find that their symptoms are not taken seriously. As a result, many mothers suffer long after the birth of their children – and they don’t receive the treatment they deserve.

Birth Trauma Awareness Week

Patient groups, including the BTA, are concerned that the NHS is failing to make improvements in maternity services, and that cases of negligence or poor treatment are too often being swept under the carpet.

A report conducted at the beginning of the year by the National Childbirth Trust found that a chronic shortage of midwives across the UK left many women feeling unsafe and frightened during childbirth, and reported a marked increase in ‘red flag’ events. A red flag problem is defined as a warning sign that something may be wrong with midwifery staffing.

Birth Trauma Awareness Week aims to highlight the issue of traumatic birth and postnatal Post Traumatic Stress Disorder (PTSD). The BTA offers support to women who are suffering from the after-effects of a traumatic birth, and actively campaigns to change those practices that contribute to postnatal PTSD.

What to do if things go wrong

Many mothers report feeling that their poor experiences don’t matter, and they should put the memories of a difficult delivery behind them. However, that is easier said than done, and PTSD is now widely recognised as a very serious and often debilitating complaint that deserves proper investigation and appropriate treatment.

Birth trauma also includes a number of physical complications during childbirth. For mothers, one of the most common issues is tearing during delivery. Tears vary in severity, and if they’re not identified quickly and dealt with effectively, they can cause long-term problems. Due to the nature of this physical trauma, mothers can experience issues in their relationship, return to work and their everyday lifestyle.

As there is currently no routine follow-up of mothers who have suffered traumatic births, if you have suffered physiological and psychological reactions following childbirth, your first step should be to make an appointment with your GP. Current NHS guidelines recommend cognitive behavioural therapy (CBT) which can offer help with psychological problems in some cases.

Placental abruption signs: Medical negligence claims

Posted on 4 January 202523 March 2025 by Sarah O'Sullivan

Understanding placental abruption: Causes, symptoms, and medical negligence claims. The placenta is the baby’s lifeline in the womb, supplying oxygen and nutrients for proper development. A placental abruption is a serious condition that can pose a significant threat to both mother and baby. In rare cases, it can lead to severe injury or even stillbirth.

If you have experienced complications related to placental abruption and believe medical negligence played a role, you may be entitled to pursue a legal claim.

What is Placental Abruption?

Placental abruption occurs when the placenta partially or completely detaches from the uterine wall before delivery. This can reduce or cut off the baby’s oxygen supply, causing serious health risks. While it is a rare complication, occurring in less than 1% of pregnancies, its consequences can be severe.

Causes and Risk Factors

Although the exact cause of placental abruption is often unknown, several factors can increase the risk:

Previous placental abruption
Abdominal trauma (e.g., car accidents, falls)
Carrying twins, triplets, or more
Pre-eclampsia (high blood pressure during pregnancy)
Uterine infections
Chronic hypertension
Drug use (cocaine or amphetamines)
Smoking

Even without these risk factors, placental abruption can still occur. Pregnant women with concerns should consult their healthcare provider for personalized advice.

Signs and Symptoms of Placental Abruption

The most common signs of placental abruption include:

Vaginal bleeding
Abdominal or back pain
Uterine tenderness
Frequent, painful contractions

In some cases, bleeding may be concealed, meaning blood remains trapped between the placenta and uterine wall. This type of abruption may present with severe pain but no visible bleeding.

Diagnosis and Treatment

Prompt diagnosis and intervention are crucial to ensure the safety of both mother and baby. Medical professionals typically perform:

Physical examinations
Ultrasounds
Fetal monitoring

Treatment options depend on the severity of the abruption and the stage of pregnancy. In severe cases, an emergency cesarean section may be necessary to prevent further complications.

Medical Negligence and Placental Abruption Claims

While most cases are managed effectively, medical negligence can occur if healthcare providers fail to diagnose or treat placental abruption appropriately. Examples of negligence may include:

Delayed diagnosis
Inadequate fetal monitoring
Failure to perform a timely cesarean section
Mismanagement of maternal bleeding

If you suspect medical negligence, you have the right to seek legal advice. At Tees, our experienced medical negligence solicitors can investigate your case and help you obtain the answers you deserve.

How We Can Help

Free Consultation: Discuss your experience with a qualified solicitor.
Expert Investigation: We collaborate with medical experts to assess your care.
Support and Guidance: Our compassionate team supports you every step of the way.

Contact Tees today to explore your options for a medical negligence claim.

Disclaimer: This content is for informational purposes only and should not replace professional medical or legal advice. Consult your healthcare provider for medical concerns and a qualified solicitor for legal inquiries.

Maternity errors result in stillbirth of couple’s first baby and significant injuries to mother

Posted on 10 September 202427 March 2025 by Sarah O'Sullivan

Sarah* had a traumatic experience when she lost her baby, and suffered from severe, permanent injuries which led to her decision to leave the UK.

The induction process

Sarah was admitted to a leading NHS Hospital based in London for a planned induction of labour. She was induced in the afternoon and contractions started that same evening. However, even though Sarah was experiencing regular contractions alongside severe levels of pain and bleeding, staff at the Hospital failed to recognise that she was in active labour. That night, the baby’s heart rate was detected dropping during CTG monitoring and there were episodes of shallow decelerations, but no action was taken.

Repeated please for help

The next day, Sarah was given a full dose of gels for induction and regular contractions started during the night. Although Sarah’s husband Daniel* made repeated requests for attention over a period of several hours, no physical checks or CTG monitoring was provided. Sarah’s contractions became more regular and painful, and Daniel again repeatedly asked for help but was ignored.

Tragic loss

On the third day, Daniel once again repeatedly asked for help and for CTG monitoring and by this point, Sarah’s pain levels had become unbearable. CTG monitoring was eventually performed but staff could not detect the baby’s heartbeat. Sarah and Daniel’s baby was heartbreakingly pronounced dead.

Lack of support

Even after the death of her baby was confirmed, Sarah was not offered any consultant support or advised of any alternative options for delivery. She was then left for seven-and-a-half hours pushing on her own to deliver her baby with no physical or psychological support from staff. Sarah’s physical condition became extremely poor, and Daniel was terrified that he would lose his wife as well as his baby. The prolonged second stage of labour resulted in severe, permanent injuries to Sarah.

Emotional and psychological impact

The experience was deeply traumatic with both Sarah and Daniel suffering from significant PTSD. Due to the physical and psychological trauma sustained following the incident, Sarah and Daniel felt they had no choice but to leave their home in London and move abroad to be closer to Sarah’s family for support.

Internal investigation and admission of liability

Following the incident, an internal investigation took place by the NHS Trust involved in which it was accepted that there was a “failure to recognise the onset of active labour during a high-risk induction process, and a failure to commence appropriate care including foetal monitoring once in established labour”.

Shortly after the tragic incident, the couple in their 30s, got in touch with Alison Hills. A letter of claim was sent to the Trust, who promptly admitted liability and accepted that had active labour been diagnosed and continued foetal monitoring been performed, then the baby’s death would have been avoided.

The Trust also admitted that a senior obstetrician should have been involved and advised Sarah about her options for delivery and that if delivery had been expedited after the death of the baby had been confirmed, then Sarah would have avoided the prolonged labour and subsequent injuries.

Ongoing compensation process

An assessment of the couple’s potential lost earnings, care costs, medical expenses, relocation costs and several other expenses is currently underway before negotiations can commence and a final compensation figure can be agreed with the Trust.

Statement from Alison Hills

Tees Law’s Medical Negligence Senior Associate Solicitor Alison Hills said: “This is one of the most tragic cases that I have ever come across in my 20-year career. Not only was the death of Sarah and Daniel’s baby wholly avoidable, but there were several failures of care even after the death was confirmed, which then led to a number of significant and permanent injuries to Sarah. Their lives have simply been turned upside down with every single aspect of their lives being adversely affected.

Whilst no amount of compensation will ever bring their baby back, I am hoping that when their case settles, Sarah and Daniel will be able to achieve some form of closure and start to heal from these heartbreaking events, and that lessons will be learnt for the Trust to avoid similar mistakes being made in the future”.

*Names have been changed to protect the privacy of our clients.

Hospital eventually settles after causing lifetime birth injury

Posted on 3 September 202427 March 2025 by Sarah O'Sullivan

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.

Coroner: Baby’s death at NHS Trust due to neglect

Posted on 22 May 202427 March 2025 by Sarah O'Sullivan

A baby who died from a brain injury following a delayed labour and delivery was failed by staff at Sherwood Forest Hospitals NHS Trust, a Coroner has concluded.

Arlo River Phoenix Lambert died on 9 March 2023 at Kingsmill Hospital, Nottinghamshire, at five days old. The Coroner found that Arlo’s death was “contributed to by mismanagement of labour and multiple missed opportunities to have expedited his delivery.”

She concluded that neglect contributed to Arlo’s death, which came from “a failure to follow Trust guidance.”

Miss Lambert, Arlo’s mother, was induced at 40+2 weeks, and following spontaneous rupture of membranes (SROM), she was left for 17 hours without any attempts made to progress her labour. The Coroner found that this allowed the risk of infection to materialise. During that time, staff failed to properly review Miss Lambert’s care plan and discuss modes of delivery with her when concerns were raised about the position of the baby and her labour was failing to progress.

Coroners findings on contributing factors

The Coroner concluded that neglect contributed to Arlo’s death, citing a “failure to follow Trust guidance.”

Miss Lambert, Arlo’s mother, was induced at 40+2 weeks. After a spontaneous rupture of membranes (SROM), she was left for 17 hours without attempts to progress her labour. The Coroner found that this delay allowed the risk of infection to materialise. Staff also failed to properly review her care plan or discuss delivery options when concerns arose about the baby’s position and the lack of labour progression.

Missed opportunities and preventable death

The Coroner identified “multiple missed opportunities to have expedited Arlo’s delivery, which would probably have prevented his death.” A Prevention of Future Deaths Report has been issued.

Since Arlo’s death, Miss Lambert has experienced post-traumatic stress disorder (PTSD).

Complaint against specialist registrar

Additionally, the Coroner made a complaint to the General Medical Council regarding the actions of Specialist Registrar Dr Adeyemi. In oral evidence, he stated that he would “cross [my] fingers behind my back and hope and pray the mother would go into labour” rather than implementing an appropriate care plan.

Evidence of brain injury

A post-mortem autopsy confirmed that Arlo’s brain had suffered a hypoxic-ischaemic injury, caused by a lack of adequate oxygenated blood supply. This was attributed to the delayed delivery following fetal distress.

Failings in antenatal and labour care

The Coroner found significant issues in Miss Lambert’s care between her induction of labour on 2 March 2023 and Arlo’s birth on 4 March 2023.

Antenatal failings

At 38+6 weeks gestation, Miss Lambert underwent a growth scan and was offered induction at 40+2 weeks due to concerns about fetal growth. However, the Coroner concluded that this decision was outside national guidelines, and Miss Lambert was not informed that the induction was unnecessary. The Coroner stated that she would likely have gone into spontaneous labour without complications.

Labour management failures

Upon Miss Lambert’s admission, numerous delays in commencing the induction occurred, exacerbated by poor communication and staff shortages.

At 11:33 on 3 March, a high fetal head position was noted, presenting a missed opportunity to consider a delivery plan. Additionally, the decision to discontinue CTG monitoring, against national guidance, prevented the detection of fetal distress.

By 17:00, Dr Adeyemi formulated a delivery plan without consulting Miss Lambert, reviewing her records, or considering her preferences.

The Coroner concluded that had the Trust’s induction of labour policy been followed, and delivery occurred within two hours of SROM, Arlo’s death could have been avoided.

Delayed caesarean section and birth complications

At 21:43, a further opportunity was missed when blood-stained liquor was reported. A lack of communication between the midwife and obstetric team meant that the mode of delivery was not reconsidered.

Doctors eventually opted for a category 1 caesarean section at 03:58 on 4 March, following concerns of placental abruption. At 04:26, Arlo was delivered via a difficult caesarean, with evidence of a placental abruption. Despite specialist care at the Queen’s Medical Centre, he died five days later.

Specific failings identified by the Coroner

The Coroner outlined the following key failings:

Failure to follow the Trust’s induction policy.
Inadequate monitoring of fetal distress.
Poor communication and staff shortages.
Lack of consideration for Miss Lambert’s informed consent.

Had Arlo been delivered sooner, the Coroner concluded that he “would more likely than not have survived.”

Calls for maternity care reform

Following a series of high-profile scandals, NHS Trusts face mounting pressure to improve maternity care. A recent Birth Trauma Inquiry condemned poor maternity and postnatal care as “tolerated as normal,” calling for systemic reform.

Family’s response and legal representation

Chantae Clark of Tees Law, representing the family, stated:

“These tragic events were preventable if Sherwood Forest Hospitals NHS Trust had followed the guidance and acted on the warning signs in the hours before Miss Lambert’s labour. It is hard to believe that in such an advanced healthcare system, a mother should suffer the treatment that she did and that a baby should die because of neglect.”

She emphasised the emotional toll on Arlo’s family and expressed hope that the Coroner’s findings and Prevention of Future Deaths Report will lead to meaningful changes in NHS maternity care.

Ectopic pregnancy: Medical negligence claims

Posted on 22 January 202224 March 2025 by Sarah O'Sullivan

Failure to diagnose, or misdiagnosing an ectopic pregnancy can be very distressing for an expectant mother. If left untreated, an ectopic pregnancy can tear or rupture the fallopian tube, which is not designed to accommodate a growing embryo. An ectopic pregnancy can sometimes lead to severe, life-threatening internal bleeding.

National incident data from the NHS shows that between April 2017 and August 2018 there were 30 missed ectopic pregnancies leading to ‘serious harm’. The Healthcare Safety Investigation Branch (HSIB) carried out a national investigation into the diagnosis of ectopic pregnancy which considered referral from emergency departments to early pregnancy services; the provision of early pregnancy services to diagnose and manage ectopic pregnancy; the information that women receive on discharge from the emergency department and made four safety recommendations.

Caring and sensitive support with Tees

Whatever your situation, our legal specialists are here to help guide you. Our expert clinical negligence lawyers can handle your ectopic pregnancy misdiagnosis claim from the initial consultation through to financial settlement.

Ectopic pregnancy misdiagnosis medical negligence claim

Doctors owe a duty of care to diagnose ectopic pregnancies and provide treatment in a professional and timely manner. An ectopic pregnancy misdiagnosis claim may arise whenever this duty is breached and the patient suffers injury as a result. Here are some examples of events that may give rise to a claim for ectopic pregnancy misdiagnosis:

misinterpretation of pregnancy test results such as blood tests and scans
misdiagnosis, for example, mistaking an ectopic pregnancy for a uterine miscarriage
failure to diagnose the condition when a woman presents with symptoms pointing to a possible ectopic pregnancy
a delay in diagnosing the condition causing a woman to undergo more invasive surgery than would have been necessary.

Gwyneth Munjoma, solicitor in Tees’ clinical negligence team, looks at the risk factors and associated symptoms – and what to do if you suffered from an ectopic pregnancy and believe that the condition could have been managed better by the doctors or nurses who attended to you.

What is an ectopic pregnancy?

An ectopic pregnancy occurs when a fertilised egg (embryo) implants and grows outside the cavity of the uterus (womb). Where an ectopic pregnancy occurs within the fallopian tube it is called a tubal pregnancy. A tubal pregnancy is the most common type of ectopic pregnancy. This happens when a fertilised egg gets stuck in the fallopian tube on its way to the uterus.

Normally, a fertilised egg travels down the fallopian tube to the uterus where it embeds itself and grows. An embryo stuck in the fallopian tube will not develop into a baby and your health may be at risk if the pregnancy continues.

In the UK, around 1 in every 90 pregnancies is ectopic. This is around 11,000 pregnancies a year. Depending on the stage at which the ectopic pregnancy is diagnosed, it can be treated using a drug called methotrexate or by an operation to remove the fallopian tube.

What problems can occur with an ectopic pregnancy?

Fallopian tubes can be damaged by inflammation or can be misshapen. Once an egg is fertilised it starts to grow rapidly. If a fallopian tube is damaged or misshapen, the rapidly growing embryo is unable to continue its journey to the uterus and gets stuck within the fallopian tube.

An embryo stuck in the fallopian tube cannot progress to a successful pregnancy, because it is restricted by the lack of space within the fallopian tube. As the embryo grows, the tube stretches and eventually may rupture; this can cause life-threatening internal bleeding, if not treated promptly.

Sometimes, an ectopic pregnancy will occur in other sites of the abdomen such as in the ovary, in the abdominal cavity or in the cervix.

What are the symptoms to look out for?

In most cases of an ectopic pregnancy, a woman will experience the early signs or symptoms of pregnancy, i.e. misses a period, breast tenderness and nausea. A pregnancy test will be positive. The first sign of an ectopic pregnancy may be pain in the pelvic area sometimes accompanied by light vaginal bleeding. Where there is internal bleeding the woman may feel shoulder pain as the pooling blood irritates the nerves. Symptoms may be variable, and a high index of suspicion should be exercised.

When should I seek help?

Seek emergency medical help if you think you are pregnant and experience any of the following:

severe abdominal or pelvic pain
vaginal bleeding
extreme lightheadedness or fainting
other concerning symptoms, especially if you have risk factors for an ectopic pregnancy.

What doctors have to consider

Ectopic pregnancy must be excluded for all women presenting with abdominal pain in early pregnancy. Successive reports into maternal deaths have highlighted the perils of not excluding an ectopic pregnancy in the circumstances.

Some things that make you more likely to have an ectopic pregnancy are:

Previous ectopic pregnancy. If you’ve had this type of pregnancy before, you’re more likely to have another.
Inflammation or infection. Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.
Fertility treatments. Some research suggests that women who have in vitro fertilization (IVF) or similar treatments are more likely to suffer an ectopic pregnancy.
Tubal surgery. Surgery to correct a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.
Choice of birth control. The chance of getting pregnant while using an intrauterine device (IUD) is rare. However, if you do get pregnant with an IUD in place, you may be at increased risk of suffering an ectopic pregnancy. Tubal ligation, a permanent method of birth control commonly known as “having your tubes tied,” also raises your risk, if you become pregnant after this procedure.

Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. The more you smoke, the greater the risk.

What is the treatment for an ectopic pregnancy?

The management of ectopic pregnancies has shifted towards medical rather than surgical intervention. The drug methotrexate has been successfully used for many years now. Methotrexate kills the pregnancy cells and any pregnancy tissue is then progressively absorbed.

In the event that it is too late to use methotrexate, the affected fallopian tube can be removed through keyhole surgery (laparoscopic surgery). However, in cases where it is not possible to successfully remove the fallopian tube through keyhole surgery, the abdomen is opened (laparotomy) and the tube is removed.

Birth injuries to mothers: Medical negligence claims

Posted on 21 December 202124 March 2025 by Sarah O'Sullivan

Birth related injuries to mothers can be absolutely devastating, and can have long-term effects. They can affect personal relationships, careers and mental health.

Some childbirth injuries are unavoidable, and they can be a natural part of having a baby. Childbirth injuries can have an impact on the psychological and/or physical well-being of a woman. Injury can occur during any pregnancy, even if the mother has no risk factors and the pregnancy is deemed to be normal. Sadly, some injuries are caused, or made worse, when midwives and doctors make mistakes during a mother’s pregnancy, labour or delivery.

Medical negligence claims for maternal birth injury

If you believe that you may have suffered a birth injury, or think that your labour and delivery may have been mismanaged or a mistake made during your care caused the problem, you might have a medical negligence claim.

Doctor or midwife negligence can cause birth injuries which affect mothers and their families for the rest of their lives. The effects of childbirth injuries are very personal and individual, but possible consequences include:

physical symptoms which affect your quality of life, such as incontinence
mental health problems, such as postnatal post-traumatic stress disorder or depression
relationship breakdown
problems bonding with your new baby
being unable to return to work because of your symptoms

If you suffered a birth injury, are worried about the care you received, and think it might have caused a problem you may be eligible for birth injury compensation. Our maternal birth injury claims solicitors understand what you’re going through, and we can help you get answers about your care.

Find out more about childbirth injuries claims.

Common types & causes of birth injuries to mothers:

Vaginal tears during childbirth

About 9 in 10 women suffer perineal tears when the perineum (the skin between the vagina and anus) stretches as the baby is born. Most perineal tears are quite minor and should heal naturally within a short time after the baby is born. However, more serious tears can also extend to the vulva (external genitals) and muscles in the anus (back passage). These require repair, take longer to heal and may have long-term effects.

Types of tears during childbirth

First degree tears are skin-deep and only affect the outermost layer of skin around the vagina and perineum. You may need a few stitches, but normally they heal quickly. First degree tears have the best chance of quick recovery with minimal pain. Normally, there is no long term damage. Your midwife will decide in consultation with you, whether it is necessary to stitch your first degree tear or not.

Second degree tears are deeper tears, involving the muscles of the vagina and the skin around the anus. Stitches are normally required to help the tear to come together and heal. Dissolvable stitches are usually used, so that the mother doesn’t need to have them removed. Second degree tears can be quite painful and recovery normally takes a few weeks. Your midwife will examine the tear from time to time to ensure that it is healing well. You should report any signs of unusual discomfort or signs of infection to your midwife.

Third and fourth degree perineal tears are the most serious form of tears during childbirth. These types of tears are typically deeper and more serious. Third degree tears damage the anal sphincter (the muscle which controls the anus). Fourth degree tears also involve the lining/muscles of the anus. Third and fourth degree tears are unpredictable. The Royal College of Obstetricians and Gynaecologists (RCOG) lists the following as risk factors:

the mother’s first vaginal delivery
the second stage of labour is particularly long
shoulder dystocia during delivery
the baby is large (over 8 pounds 13 ounces)
labour is induced
an assisted delivery (for example, if forceps or ventouse are used).

If you are concerned about suffering a serious tear during birth, you can talk to your or midwife or doctor about it during your antenatal care. They may be able to recommend measures to help reduce the risk of a serious tear, such as perineal massage. Perineal massage helps the perineum to be more elastic and can help reduce the risk of it tearing as your baby is born. Another option is an episiotomy, a procedure designed to reduce the risk of a serious tear.

What is an episiotomy?

An episiotomy is a surgical incision made by a doctor or midwife during childbirth. It is a deliberate cut designed to expedite delivery and help reduce the risk of uncontrolled tearing of the perineum. This incision makes the opening of the vagina wider, so there’s more room for the baby to pass through.

There are two types of episiotomy you might hear about:

midline episiotomy – a cut from the vagina directly towards the anus (rarely done)
mediolateral episiotomy – a cut from the vagina, but angled off to one side of the perineum. Mediolateral episiotomies are more common in the UK.

Midwives and doctors should only recommend an episiotomy if there is a medical need, or the mother specifically requests one. It may be the best course of action if your baby is in distress and needs to be born quickly, if they are in a difficult position or if you are having an instrumental delivery using forceps or ventouse.

Some women may prefer an episiotomy over a spontaneous (natural) tear. Spontaneous tears can cause serious, lasting damage to the muscles around the vagina and anus but are said to heal better. Studies show that episiotomies reduce the risk of suffering a serious tear. Your doctor should explain the risks and benefits of an episiotomy to you before performing one.

Failure to identify and repair tears following childbirth

If you suffer a perineal tear, your caregivers should identify the tear at delivery and manage it appropriately. You can also find more information and support regarding perineal tears from the charity MASIC (Mothers with Anal Sphincter Injuries from Childbirth).

Following delivery and for the rest of your postnatal care, your midwife will ask you about the condition of your perineum and where necessary examine the perineum. Care of your perineum forms part of your post-natal midwifery follow up. Serious tears and episiotomies can, unfortunately, cause a great deal of suffering if they are unnoticed and not repaired at the time of delivery or if they’re repaired poorly. For example, they can cause complications such as:

incontinence – lack of control to pass faeces (stool) and/or wind
rectovaginal fistula – a serious tear can cause a hole in the wall between your vagina and your anus, which can cause faeces to pass through into the vagina
pain and soreness – the tear may make it difficult for you to sit for a long time, or be very active
stinging pain when passing urine
pain during sexual intercourse.
scarring.

It may also mean you need another procedure to correct the damage (secondary repair), causing further pain and distress.

If you suffered a third or fourth degree tear, if this was not identified and repaired at the time of delivery, and if you suffer continuing problems as a consequence, please contact our Obstetric Anal Sphincter Injury experts, Janine Collier and Gwyneth Munjoma for compensation advice.

Post-natal depression (PND) and post-natal post-traumatic stress disorder (PTSD)

A negative experience before, during or shortly after childbirth (‘birth trauma’) can affect mental health and wellbeing. Negative experiences during childbirth are highly personal, and everyone reacts differently. However there are some common signs and symptoms, for example:

difficulty bonding with the baby
a sense of ‘failure’ – that the circumstances surrounding baby’s birth were somehow their fault
feeling isolated or guilty
avoiding situations reminiscent of the birth (going to hospital, seeing birth depicted on television).

Many mothers suffer in silence. However, post-natal PTSD and post-natal depression needs the right treatment and support. Get further information about psychological damage after childbirth.

If you suffered post-traumatic stress disorder or post-natal depression following a traumatic delivery contact our experts Gwyneth Munjoma or Janine collier for advice.

Post-partum haemorrhage (PPH)

Women experience some blood loss after giving birth. Vaginal bleeding is normal for about 2 to 6 weeks after the baby is born. The bleeding is normally heaviest in the days immediately after delivery, becoming gradually lighter over time.

However, some women experience abnormally heavy bleeding, which can be dangerous. This is called a post-partum haemorrhage (PPH). There are two types of PPH:

primary or immediate PPH – heavy bleeding within 24 hours of the baby’s birth
secondary or delayed PPH – heavy bleeding after 24 hours, and up to 6 weeks after the baby’s birth.

Primary PPH happens in about 5 in 100 pregnancies. Normally, about 500ml (1 pint) of blood may be lost. However, in very rare cases, a particularly severe haemorrhage can lead to blood loss of around 2L (4 pints) or more.

Secondary PPH is rarer and affects less than 2 in 100 women. It normally happens if the mother suffers an infection following delivery. A major bleed can be life threatening. Midwives and doctors are trained to recognise situations where a mother is at high risk of suffering a PPH. They should take the necessary steps in order to reduce the chance of a haemorrhage – or prevent it altogether. And, if a haemorrhage does occur it is important to treat it quickly. Doctors and midwives are trained in controlling heavy bleeding.

If you suffered a post-partum haemorrhage and are concerned about the medical care you received contact Janine Collier or Gwyneth Munjoma for advice.

Ruptured uterus

A ruptured uterus is a serious complication during pregnancy. It happens when the wall of the uterus (womb) tears during pregnancy. It’s more common in women who have previously had a caesarean section, at the site of their caesarean section scar.

It is very important that doctors and midwives diagnose and treat a uterine rupture promptly. A ruptured uterus is considered a medical emergency because it can be life-threatening to both the mother and the baby and cause serious damage to the health of the mother and baby.

First line treatment is urgent caesarean section and uterine repair if possible (hysterectomy if not). Usually, the mother loses a lot of blood and needs a transfusion and antibiotics to reduce the risk of infection. It can take a little time to recover from losing so much blood and the surgery itself. Women who have more children in the future will need a caesarean section.

If you suffered a ruptured uterus and are concerned about the medical care you received contact our maternal birth injuries experts, Janine Collier or Gwyneth Munjoma for advice.

Prolapsed uterus

Childbirth can also cause pelvic organ prolapse. This is where one of more of the pelvic organs bulges into the vagina. It’s quite common, and the NHS states that up to half of mothers are affected by some level of prolapse.

Pelvic organ prolapse is more likely in cases where labour was particularly long or difficult, or the baby was particularly large.

A prolapse of the uterus (womb) happens when the uterus slips out of its normal position and down into the vaginal canal. Most of the time, a prolapsed uterus or other pelvic organ isn’t life-threatening. However, it can affect the mother’s quality of life and general wellbeing significantly. Possible symptoms include:

urinary incontinence
pain during sex
a feeling of heaviness in the vagina and/or perineal area.

Many cases of a pelvic organ prolapse can be managed through pelvic floor exercises, treating any constipation and weight loss (if appropriate). However, if you suffer a serious prolapse it might require more invasive treatment such as a hysterectomy (removal of the womb, which means the woman cannot have any more children) or surgical repair of the pelvic floor muscles.

If you suffered a prolapsed uterus and are concerned about the medical care you received talk to our maternal birth injuries experts, Janine Collier or Gwyneth Munjoma.

Medical negligence claims for maternal birth injuries

physical symptoms which affect your quality of life, such as incontinence
mental health problems, such as postnatal post-traumatic stress disorder or depression
relationship breakdown
problems bonding with your new baby
being unable to return to work because of your symptoms

Caesarean Section Requests

Posted on 9 December 202124 April 2025 by Sarah O'Sullivan

A report on the variations in practice and procedure across NHS Trusts in the UK

At Tees, we are increasingly supporting women who, despite requesting a caesarean section or raising concerns about vaginal delivery, have been counselled in a way that steers them toward a vaginal birth.

Many of these women are unaware that nearly 40% of births in the UK involve either instrumental assistance or a caesarean section. For first-time mothers, this figure rises to 50%. Furthermore, around 4% of women experience third or fourth-degree perineal tears during childbirth, which can result in life-changing, long-term issues with bowel control and incontinence.

Sadly, many go on to endure traumatic births, often leading to serious and lasting physical and/or mental health problems. In some cases, their babies also suffer injury.

Read Tees Law’s own report

The copyright in this report belongs to Tees Law. Tees Law gives permission for extracts from the report to be used provided a suitable credit to Tees Law is given and a link to the full report published.

In 2018, Birthrights – a charity dedicated to promoting women’s rights in childbirth, published a report into Maternal Request Caesarean (MRCS). These are planned caesarean sections requested by pregnant women without a medical indication.

The report revealed that, despite NICE Guideline CG132, nearly 75% of NHS Trusts did not have written policies supporting a woman’s right to choose a caesarean.

It concluded that “the majority of Trusts in the UK made the process of requesting a caesarean lengthy, difficult or inconsistent, adding anxiety and distress to women at a vulnerable time.” The report called for greater transparency around the variation in policies and procedures between NHS Trusts.

Three years have passed since the Birthrights report was published. With no further research on this issue that we were aware of—and with our Medical Negligence team continuing to support women like Niamh and Anna, who have faced disempowerment and difficulty when giving birth—we undertook our own investigation in May 2021. Our goal was to assess whether practices and procedures regarding MRCS had changed across NHS Trusts since 2018.

Trust failed to advise woman on risks and benefits of vaginal delivery vs. caesarean

Posted on 9 December 202128 March 2025 by Sarah O'Sullivan

Ensuring informed birth choices: The importance of understanding risks.

Childbirth is a significant life event, and while most experiences are positive, complications can arise. Informed decision-making during the antenatal period is crucial to ensure the safety and well-being of both mother and baby.

The need for informed choices

Expectant mothers should receive comprehensive, unbiased information about the potential risks and benefits of various birthing options, including Caesarean sections, vaginal births, and other interventions. This empowers them to make decisions aligned with their individual health needs and preferences.

However, in practice, the risks of vaginal births are often underrepresented compared to those of Caesarean sections. Many women remain unaware that in the UK:

Nearly 40% of women undergo instrumental delivery or Caesarean section.
50% of first-time mothers experience these interventions.
4% of women suffer third or fourth-degree tears, leading to long-term bowel control issues and incontinence.

Lack of comprehensive counseling

At Tees Law, our Medical Negligence team has supported numerous women who faced traumatic childbirth experiences. Despite expressing concerns or requesting a Caesarean section, some were advised against it without a full understanding of the risks of vaginal delivery.

Anna’s story: A preventable trauma

In 2018, Anna (not her real name) suffered a third-degree tear during vaginal birth. Despite having pre-existing bowel difficulties, including slow transit and severe constipation, her concerns about vaginal delivery were repeatedly dismissed. Her visual impairment added to her vulnerability.

Missed opportunities

Throughout her pregnancy, Anna consistently raised concerns:

She was advised to stop taking stimulant laxatives without thorough discussions on alternative options.
Her repeated questions about Caesarean delivery were met with reassurances that vaginal birth was “safest for the baby.”
Risks associated with vaginal delivery were not communicated, despite her history of bowel issues.

When her baby was positioned “back-to-back,” increasing delivery risks, she was still discouraged from a Caesarean.

Traumatic delivery and lasting impact

Anna endured two days of contractions, leading to an instrumental delivery using forceps without an episiotomy. Following the birth, she was informed of her third-degree tear and its consequences, which severely impacted her quality of life.

Despite her long-standing bowel condition, appropriate postnatal care and medication were delayed. She continues to experience bowel urgency, incontinence, and symptoms of Post-Traumatic Stress Disorder (PTSD).

The fight for justice

Anna’s experience is not isolated. NICE guidelines state that if a vaginal birth remains unacceptable to a mother after counseling, a Caesarean section should be offered. However, a 2018 Birthrights report revealed that only 26% of Trusts adhered to this best-practice guidance.

At Tees Law, we are committed to holding healthcare providers accountable for failures in maternal care. Our experienced Medical Negligence solicitors support clients in pursuing justice, ensuring their voices are heard and their rights upheld.

Contact us

If you or someone you know has experienced medical negligence during childbirth, our dedicated team is here to help. Reach out to Tees Law today for expert legal support and compassionate guidance.

Woman suffers severe injuries and PTSD after denied caesarean request

Posted on 9 December 202128 March 2025 by Sarah O'Sullivan

Most women who give birth vaginally do so safely and without any long-term health issues. However, according to NHS data, around 4% of women suffer third- or fourth-degree tears during childbirth. In some cases, complications can result in severe and life-changing maternal injuries.

Sadly, Tees Law’s specialist Medical Negligence team knows only too well the devastating impact of such cases. One example is Niamh who experienced a third-degree tear following a vaginal birth. This was despite Niamh having expressed a preference for planned caesarean section. Her claim against Kingston Hospital NHS Foundation Trust is based on breaches of duty before, during and after delivery.

Lack of informed consent

Niamh became pregnant in early 2018.

At 16 weeks, she met with a male registrar and explained that she expected she would need to have a C-section because all the women in her family had given birth that way. In addition to her family history, Niamh’s very slight build further suggested that C-section would be the best method to deliver her baby. Niamh recalls: “the registrar looked me in the eye and said that ‘we would very much support a vaginal birth at this stage’. lt felt to me from the outset like it was going to be a battle to get a c-section and that I was being told that I didn’t need one, despite my family history. To be told so early on that I would need to have a vaginal delivery, made me really anxious.”

Later on at her booking appointment, Niamh also explained her family history of c-sections to the midwife. The midwife referred Niamh to Birth Options to discuss the mode of delivery. There, she was told that a vaginal birth would be much better for the baby. She was also informed that a vaginal birth would allow her to get back to her daily routine sooner. Additionally, she was warned of the risks of having a C-section, including the potential to lose a lot of blood.

Throughout the antenatal process, Niamh repeatedly asked about having a C-section. At 26 weeks, it was noted that she felt “very anxious about [the] birth and uncomfortable within the hospital”. She expressed doubts about her ability to give birth vaginally but was nevertheless encouraged to pursue this route. In the end, based on the medical assurances she had received, Niamh agreed to proceed with a vaginal birth.

An assisted delivery

A week before Niamh went into labour, an ultrasound scan revealed that her baby was back-to-back, a position that increases the risk of complications during delivery. At this point, Niamh asked again if this meant she should have a C-section. She was told that the baby would likely turn around and there would be no problem.

In October 2018, Niamh went into labour spontaneously at 40 weeks. The baby remained back-to-back, and Niamh could not deliver so she was taken to theatre for assisted delivery. A C-section was not offered to Niamh. Instead, the baby was delivered after three pulls of the ventouse and four pulls of the forceps. Her daughter, Darcey, was born safely, but the instrumental delivery caused Niamh to sustain a Grade 3 tear, along with significant and irreparable muscle damage.

Postnatal negligence

Niamh bled heavily for 16 days after giving birth. She suffered faecal urge symptoms and abdominal distension, and her haemoglobin levels fell to 52 grams per litre. On day 5, she was given an X-ray but was refused a CT or MRI scan. The X-ray didn’t reveal anything and despite her symptoms, Niamh was told there was nothing untoward. Niamh pressed for a CT or MRI scan but continued to be refused. Finally on day 9, after having to wait a full weekend and only after continuing to press further, an ultrasound was performed, which failed to detect any medical issue.

Finally, a CT scan was arranged and Niamh was subsequently diagnosed with a pelvic haematoma requiring surgery.

After this, she was unable to pass urine. Several attempts at trial without catheter failed, but instead of being referred to uro-gynaecology, she was discharged with a catheter.

Niamh was in and out of hospital several times during November 2018 to attempt a trial without catheter (TWOC). Eventually, Niamh sought her own private consultant and on the consultant’s medical advice, went back to the NHS to request a suprapubic catheter.

Niamh was re-admitted in late November 2018 and underwent further surgery to insert the suprapubic catheter into her stomach, a procedure which she found extremely distressing.

Niamh’s catheter was not removed until the start of January 2019. During this time, she experienced coccyx, groin and deep pelvic pain, as well as faecal urgency. Since then, Niamh has continued to suffer from psychiatric injury. She has been diagnosed with PTSD and also suffers chronic coccyx pain, which causes her to wake up in pain. She also suffers urgency of continence and has not been able to return to work.

Failures at every stage

There were medical failures at every stage in Niamh’s story. In antenatal meetings, she was not properly counselled as to the pros and cons of C-section compared to vaginal delivery. Having expressed concern regarding the risks of giving birth vaginally, specifically in relation to her family history of C-sections, Niamh was assured that this was the best method of delivery. At no point was she presented with a balanced picture of the benefits and risks of each option. If she had been warned of the risks associated with vaginal delivery, she would have chosen a C-section.

Although she knew there was a small risk she could tear, Niamh was not warned this could lead to difficulties with continence. Moreover, she was warned of the dangers of C-section and the potential disruption this could cause to her recovery, but she was not provided with an equivalent risk assessment of vaginal delivery. For example, she was informed that she could suffer excessive bleeding with a C-section but was never told that this could also happen with a vaginal delivery. Niamh was also not informed about the risk of requiring instrumental assistance.

During labour, there was an opportunity to perform a C-section yet Niamh was not offered the option of a C-section. Furthermore, once assisted delivery with ventouse and forceps had been chosen, there was a failure to manage the delivery in such a way as to avoid the tear.

Finally, Niamh experienced negligent postnatal treatment. There was a delay in escalation, imaging, identification and treatment of the haematoma. Had the haematoma been diagnosed and treated earlier, the extent of the infection would have been less severe. Because of the failure to treat in a timely manner, her episiotomy wound broke down twice and wasn’t able to heal properly which has resulted in the formation of extremely painful scar tissue.

An all-too-common problem

Ultimately, had Niamh been able to go ahead with her preference for a planned C-section, she would have avoided the third-degree tear, haematoma and the rest of the consequences that have resulted from her instrumental delivery. Unfortunately, Niamh is not alone in suffering injury and long-term complications from a vaginal birth that should have been avoided.

Official NICE guidelines state: “For women requesting a caesarean section, if after discussion and offer of support… a vaginal birth is still not an acceptable option [Trusts should] offer a planned caesarean section.” Yet a report by Birthrights in 2018 revealed that only 26% of Trusts offered C-sections in line with NICE best-practice guidance.

Here to help

Our Medical Negligence solicitors are devoted to achieving the justice our clients deserve. If you have been affected by medical negligence, we can support you on your journey to justice, looking out for your needs and priorities every step of the way.