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Advice for a desperate new mum - Perineum, clitoral and labia tear - will it ever get better?

(67 Posts)
BeaRuss Sat 01-Sep-18 15:41:32

Hello,

I had a beautiful baby 5 weeks ago and the birth was pretty horrendous. The hospital didn't think I sounded far enough along when I phoned to go in when I was in labour so told me to stay home and call back after an hour or two. Basically, I was a lot further along than they expected and an hour later I was pushing. Baby ended up being delivered at home - my husband did most of the hard work before a midwife arrived as the baby's head was beginning to crown. I do need to say, I don't mean to talk ill of the midwife, she delivered my healthy baby boy and for that I'll always be grateful. It wasn't her fault that I was delivering at home, however she didn't have half her kit on her and she kept leaving through the actual delivery to go to look for things in her car, so it wasn't great.

Anyway, baby's head was on an angle so he wasn't moving very much through the birth canal. The midwife kept checking his heart rate and it was quite elevated so we knew I had to get him out. Really it should have been an assisted delivery or a c-section, but since we were at home those options weren't available! She said she would do an episiotomy but then realised she didn't have her scissors on her so I had to tear naturally. She was really tired and clearly just wanted to go home - everything was very rushed and she made it clear she wanted to leave once the baby was out (she even gave him a bottle of formula milk as he didn't latch on my breast straight away). She said I had a second degree perineal tear and she would suture it there and then, which she did. She finished up and went off on her way, and that was that. Except it wasn't...

I was in a lot of pain for days after the birth and kept being told by the midwives who came to the house in the following days that that's normal. They did have a look but I was so swollen that they couldn't really see much. Then about a week after birth, a midwife checked and sent me to the hospital to be seen. A consultant saw me who told me that the tear was actually very bad, and that the stitches had come undone. She told me I had a clitoral tear and my labia had also quite badly torn. The perineum tear also extended into my bum (sorry, TMI!). I was put on antibiotics as where it was all exposed it had become infected. When she was having a look she asked if I'd been admitted to hospital straight after birth so I explained that the midwife had sutured at home. She asked if I had refused admission and I said the midwife didn't even mention going to hospital, she just sewed me up and left. The consultant told me that I should have been admitted as I would have likely needed surgery. She said to take the antibiotics and to go back in two weeks so she could see the extent of the tears once the infection had gone. She said it was likely I'd need to be resutured as nothing was being held together anymore. She arranged for me to be regularly seen by midwives in the interim so that they could keep an eye on it.

However I didn't see a midwife then for over a week as my son was admitted to hospital and I was staying with him. I did phone the midwifery team to tell them and asked if I could be seen as they were in the same hospital but nobody turned up. I then asked to be seen once we were back home and a midwife came out to have a look at how things were healing. She wasn't happy with it so I was sent back into hospital where I saw another consultant. He had a look and told me that I had a fourth degree tear and that it was very severe, but because of the time that had passed it would cause more damage to resuture and it would be best to leave it. He told me if they resutured it would probably come apart again anyway and that it would cause even worse scarring. Basically I was told to leave it, see how it heals over the coming months and if it is causing problems months down the line they would review whether it needed to be 'refashioned'.

I was ok with that as I was told chances were it would heal naturally as I am young, however I've just had a look at it for the first time and I'm an absolute mess...again, sorry, TMI! The tear is so far apart and there are no stitches holding anything together so I don't see how it's going to heal and join back together. I'm not so concerned about the perineal tear, I'm more worried about the clitoral and labia tears. I don't see things ever going back together down there. It has started to heal apart already and I can't even tell what used to be where ☹😳 even though it is starting to heal I'm still in a lot of pain and am still bleeding. I have no idea how the tears are going to affect me in the future but I don't imagine my sex life will be the same. The damage to my clitoris is so extensive I'm not sure what that will be like in the future. I feel so unattractive now and so ashamed of how I look.

Has anybody had a similar experience or healed from a severe clitoral or labia tear when it hasn't been sutured together? How long did healing take?

If you've made it this far, thank you so much for keeping reading!! I'm really hoping there will be somebody who has had a similar experience with a positive outcome 🤞🤞

Thank you! X

OP’s posts: |
Chrisinthemorning Sat 01-Sep-18 15:45:23

flowers
No advice (ELCS here), but sympathy, that sounds horrendous. You need to be really strong and vocal and fight to get all this repaired, you need to see a consultant obstetrician ASAP surely?
I’m a HCP myself so wouldn’t advise complaining normally but in this case I think you have to to protect other women.

Bountiful Sat 01-Sep-18 15:49:07

To me, the one at fault here is the one who told you to stay at home! I genuinely don't know what recovery there is? Have they told you?

Cornish83 Sat 01-Sep-18 16:09:09

GOSH! You poor girl, that's sounds barbaric, You deserve to have your questions answered by a professional, don't be fobbed off keep going back until you are happy it's your body.

Chrisinthemorning Sat 01-Sep-18 16:13:39

@Bountiful
No the MW attending should have been able to assess the tear as too severe for her to repair and arranged transfer to hospital surely?
The fact she tried to stich it (badly) means she was working beyond her competency surely?
www.nmc.org.uk/standards/code/read-the-code-online/#fourth

sar302 Sat 01-Sep-18 16:18:07

Not quite the same, but I had an episiotomy and the stitches got infected and "healed open" whilst I was treated. They couldn't restitch because of the infection. It just looked like a gaping hole for a while, but it sort of builds tissue from the bottom of the wound up and fills the wound hole... hard to describe exactly. 9 months later, I don't have much perineum left, but it doesn't hurt and no longer looks too weird.

My labial tear hurt for ages when I wiped after the loo (TMI) and still sometimes hurts during sex angry that was only one stitch too, so god knows why it feels so bad.

Can't comment on the clitoris.

Absolutely do not accept them doing nothing after a 4th degree tear, as a minimum you should have a scan to check the damage, as 4th degree means you have torn all the way to your bottom and this may affect your bowels. You may also have significant damage to your pelvis floor without knowing it. I couldn't feel the extent of the damage to mine until all my cuts and tears healed. You need a referral to a urogynaecologist and then on to a specialist women's health physio to assess your pelvic floor function.

It's a long journey, but you're not alone.x

sar302 Sat 01-Sep-18 16:18:46

Oh, and request a birth debrief - this will be done with a senior practitioner - and get a copy of your notes.

RaymondHolt Sat 01-Sep-18 16:19:08

I think you should have grounds for a negligence complaint. Can you contact your local PALS? I really hope you get the help that you need.

FortyFacedFuckers Sat 01-Sep-18 16:21:23

I’m so sorry this happened to you OP.
When I had my DS 13 years ago I had a quite severe labia tear which wasn’t stitched it did heal but not together, I was young and scared at the time do just left it but I do wish I had pushed to get it fixed.

BeaRuss Sat 01-Sep-18 16:23:01

Thank you both for the response (I'm new here so have no idea how to tag you!). I have kept asking to be seen by somebody to look at getting it sorted and have been told by registrars and consultants that at this point there's nothing that can be done. They said they don't like to resuture and sort of that the damage is already done. They keep focussing on the perineum tear and brushing over the other tears when I ask if they are going to heal. All I hear is 'you're young, hopefully your body will repair itself'. I've had a couple of HCP's who saw me who have hinted that a major mistake was made when I wasn't admitted to hospital as they've said I really should have gone for surgery. I've been signed off from midwifery care now and feel like I've just been left, like nobody wants to deal with it because things have been messed up so badly. I don't know where to go from here.
In terms of recovery, I just keep being told that it'll take a long time but 'hopefully it'll heal' 😣☹

OP’s posts: |
BeaRuss Sat 01-Sep-18 16:28:21

Hi Forty, thank you for the response. I'm not sure who I should go to, I feel like I'm hitting a dead end at the hospital. I may go to my GP and ask for a referral somewhere. I've been told that my health board are against refashioning and will only consider it after 6 months if the person is still in a lot of pain.

OP’s posts: |
Bountiful Sat 01-Sep-18 16:28:32

I had a traumatic birth but for totally different reasons. I woke up one morning and blood was pouring out of me - like gushing out of me. I rang the hospital and they asked me A could I drive (?) or B could I get a taxi (?). I was screaming at them that I was losing my baby so they sent an ambulance. Meanwhile I called a taxi who wouldn't take me because I was pouring blood everywhere so ambulance arrived and pretty much panicked with the amount of blood everywhere. They got me to hospital and the bleeding stopped. I had a ruptured placenta. Bleeding started again ferociously at about 9pm and dd was born by c section at 10.10pm.

Anyway, I'd get my arse to hospital any way you can. They can be very blase about births...

Babdoc Sat 01-Sep-18 16:28:34

It sounds like utterly
negligent management by the midwife. She shouldn’t be doing home deliveries if she can’t even organise and perform an episiotomy, or diagnose which perineal tears need hospital admission and consultant repair.
I think you should make a formal complaint to your local health trust and consider consulting a “no win no fee” negligence lawyer. The reason I suggest that, is to put the fear of God into the Trust, so they treat you as a high priority, to try and fend off being sued. That should mean you get a rapid consultant assessment and a proper repair, done by someone who actually knows what they’re doing!

Bountiful Sat 01-Sep-18 16:30:04

I'd ask everyone you talk to until they blooming get you the right person?

Megthehen Sat 01-Sep-18 16:31:14

Please contact PALS at your hospital and share your medical history and issues with them. They are a way to get heard - must be difficult to have so much going on down there and yes to previous poster re pelvic floor - specialist physiotherapy for that.

Good luck

Rainycloudyday Sat 01-Sep-18 16:43:09

You poor thing, that sounds awful. Please don't minimise the midwife's behaviour here-from what you have said it sounds totally negligent and I echo others in saying you should consider a formal complaint of legal action, if nothing else to show the practitioners dealing with you that you won't just shut up and go away. It's so hard when you're vulnerable after birth but you need to jump up and down a bit here-start with your GP and tell them you won't be leaving the surgery without an appropriate referral. Congratulations on your baby and I hope this isn't overshadowing it too much.

mumtothebabes123 Sat 01-Sep-18 16:45:41

I don't often comment on many threads
But this is one of the worst things i've ever read on here.. you poor woman
They think you had a 4th degree tear and you weren't repaired correctly, I haven't had a 4th myself but i am on various support pages for severe tears and am I right in thinking a 4th is into the anal passage?
Surely she couldn't have missed that?
I'm utterly speechless, beyond angry on your behalf And so so sorry this has happened to you

Do you have Facebook? If you do please join
'Birth tear support (severe birth tears)' facebook page
Lots of women who have lots of experience of various degrees of tears

Things will get better but you need to push for support and treatment!

Sending you a massive hug x

BeaRuss Sat 01-Sep-18 16:48:04

Thank you for all the responses. I think I will ask for a birth debrief so at least I can know what happened. It all happened so fast and I just trusted what the midwife was doing but I'd like to understand why things happened the way they did. I think the midwife was tired and made a bad call - there were paramedics here too and she didn't let them leave for ages after the birth, but once she told them she would suture she said they could go which makes me think she did consider sending me in. She must have thought she could do a good enough job at home. Obviously that wasn't the case though!

OP’s posts: |
WhirlingTurkey Sat 01-Sep-18 16:54:17

Dear God, you poor thing. That is horrific. Please think about taking action against the hospital/midwife, and contact PALS - the midwife shouldn't be working IMO, she sounds completely incompetent. I'm almost speechless to be honest.

Warmsunny Sat 01-Sep-18 16:55:18

@BeaRuss
I'm sorry you're facing this. I'm not sure who you're seeing next but what you need is to be referred to a pelvic floor clinic or urugynaecology department AND colorectal department. A pelvic floor clinic should link with colorectal without you needing another referral. Your GP (sometimes midwives) is normally the one who refers you.
I'd advise that from that point onward you never finish an appointment without knowing exactly what the step is/when your next appointment is and with who. It's exhausting to keep on top of it all but it's the only way to get the care you need. Be forceful. If you think the person in front of you is dithering, ask them bluntly if they've had a case like yours before.

Long story but had a Fenton procedure 18 months after birth so talke to urugynaecologist several times. Had concerns about my clitoris and she said she had only seen 2 clitoral tears in 20 years. They are rare. Don't let anyone who doesn't know what they are doing do surgery on you. I don't know exactly what needs doing but do ask what experience the surgeon has for particular procedures.
There's a Facebook group called Birth Tear Support where you should find help.

I'd strongly recommend getting as much support as you can with the baby so you can get the time you need to rest and also to go to appointments which will become regular.

If you want to complain (and you have every right to do so), contact PALS and write a letter of complaint. If later you want to see if you can sue, you'll need to contact personal injury solicitors before your baby's second birthday. You have 3 years after the injury to start a claim (you may not win but you might want to start the process to see what solicitors say) but it takes one year to put a case together. I know this is not the priority now but I think it's better you know how it works if you decide to go ahead.

Sending you a hug.

onetimeposter Sat 01-Sep-18 16:55:50

Very similar. 15 years on, things are baggy. It looks mangled. I still get pain on the scar side as i ripped into muscle. I find sex v painful, lack sendation as it has no defined 'entrance', just a hole hidden somewhere amidst flaps of skin. Also get pain down the leg on the ripped muscle side. I struggle to voud urine due to scar tissue. Due to the pain I also have no idea what needing a poo feels like so can end up very constipated.

onetimeposter Sat 01-Sep-18 16:56:34

Make them give you reconstructive surgery. Dont end up like me.

delphguelph Sat 01-Sep-18 17:00:10

I have absolutely no advice whatsoever but your whole experience sounds awful, the midwife should be fired and you need some sort of counselling.

Not wanting to make this about something or than you, op, but this would not happen to a man. If his dick was hanging off by a thread he'd have had surgery by now. Dispicable.

delphguelph Sat 01-Sep-18 17:00:32

Something other than you, op

delphguelph Sat 01-Sep-18 17:02:09

. I think the midwife was tired and made a bad call -

No excuse. Not a lot.

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