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

[BeaRuss]

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 his sounds awful. My SIL had a 3rd degree tear which required a lengthy surgical repair followed by a year of physiotherapy and another operation to tidy up the scar tissue. How your midwife thought she could repair a 4th degree tear on her own at home beggars belief. She is incompetent and needs to be struck off. Please pursue this further before she damages someone else.

I suffered for two and a half years after rhe birth of DS1 before seeing a consultant privately and ended up having 2 lots of reconstructive surgery followed by scar tissue removal. Please do it sooner rather than later.

I then successfully had my second child 9 years later (!) with no intervention or nees for stitches. I was terrified it might happen again but my consultant was happy to induce me at 37 weeks to help prevent the same happening again - although would not let me have a c-section as no medical reason to do so.

Please don't put off asking for referral for whatever reason - whether being fobbed off, embarrassed or otherwise.

Hello,

I can't believe how many replies I have had to this, thank you so much! It has been great to hear everyone's experiences and positive that there are some of you who healed well and who are able to get on with life as normal.

I will be booking an appointment with my GP and will ask for appropriate referrals from there. I'm lucky also that my husband gets private healthcare with work and this policy will cover myself and my son so I will look at going private, even if only to be told what needs to be done and to get some answers.

I haven't wanted to complain as I don't want to ruin somebody's livelihood and the midwife who delivered the baby is really well respected and has a good reputation. Every HCP I have seen so far has been really shocked that she was the one delivering the baby as she is known to be very good, so I have no idea what was going on that night. I will say however, I don't think she realised the extent of the tear. I was unbelievably swollen and my mum was watching me being stitched and said it was really hard to tell what anything really looked like because I was so swollen. I'm not making excuses for the midwife, I'm just saying I don't think she assessed the extent of the tear fully. However as much as I haven't wanted to complain, it's something I will consider if I'm not taken seriously. Thank you all for so much support and reassurance that what happened was not on.

The advice you have all given has been amazing and I now have lots of different avenues I can go down for support. Thank you so, so much!! ❤ I posted expected to not get any replies so I really do appreciate you all taking the time to respond, you've made a desperate and confused new mum feel a lot less lonely x

...but you ARE making excuses for the midwife, and by allowing her amazing reputation to be upheld (by your silence) this may happen again to another woman...

All the best for getting it all fixed, you deserve it, fight for it! This is not something you should just accept (and I 'm glad you don't)

I haven't wanted to complain as I don't want to ruin somebody's livelihood
But it’s ok for her to ruin your health and your life? Screw her livelihood - she needs to be stopped before she butchers someone else and ruins their life too.

It sounds to me like your midwife was ill prepared and negligent. Contact PALS at the hospital. Request a copy of all your notes and get legal advice. You've been totally messed about. I'd also want reassuring that there's no lasting damage to baby as the birth was difficult.
You need to make a list of questions and ask for a meeting with head of department. Why were you not admitted.....was there no beds? This initial decision led to where you are now and could have been avoided. You need answers and lessons need to be learned.

This sounds horrific

Sweetheart, you need to stop minimising.
Your treatment was negligent and everyone in that chain of events needs to be made to reflect on their part in it.
I would honestly consider bringing legal action. I think you will find they are much more inclined to repair you properly then. Left unsorted this sort of damage can be lifelong.

I’m so sorry you’ve got to be the one pushing it all (no pun intended) but you need to escalate this now.

Sorry, posted too soon. I would document everything that happened that night and in the subsequent checkups so that you have a clear record in case of further legal action. I think the mistakes made here do warrant further action to make sure you get the corrective surgery and access to the specialists you need. I know you say you don't blame the midwife but it sounds like she made some serious judgement errors.

Personally I think getting yourself fixed should be the priority over complaining right now.

I complained about DS1’s unsafe birth and was met with lies, denial and a complete failure to produce my medical notes after several requests. It took more energy than I had frankly and it was incredibly upsetting to have my very poor experience entirely denied.

I’d focus on yourself and your baby at first and see how you feel about complaining once that is in hand.

This sounds appalling. What a traumatic experience for you.

I have no specific experience of your situation, but it in a world where they can perform face transplants I can't imagine your vulva is a lost cause. I suspect you'll need to kick up a fuss about what happened and be brutally honest about the physical and psychological effects that are ongoing.

You come across as remarkably level headed, this is a positive attribute but don't let it mask the reality of the nightmare you've been through.

Congratulations on your new baby. And I hope things are sorted for you.

@bearuss

OMG you poor poor thing. This sounds absolutely awful and very traumatic for you.

I agree with all the comments. This midwife even with her good reputation failed you on the delivery on your baby and repair. If they are stating you had a 4th degree tear and she resutured you as a second, she missed a severe perineal injury.

Usually within a hospital if a midwife is unsure, a docter would come and check by inserting a finger in your rectum to assess spincter. Did the midwife do this? Midwives aren’t trained enough in assessing what level of tear beyond 2nd degree which is usually why a docter is called to confirm what actual damage there is.

I had a 3B tear and was taken to theatre immediately and was in there for over 2 hours. I also had an episiotomy and a fair amount of damage and things are quite different down below now. Mine was repaired straight away and I still suffered immense amount of pain for weeks and months actually. But obviously mine has now all healed and touch wood not too many lasting issue. (Yet)

If she only sutured you as a second, it means she left your torn spincter just as that, torn. Have you had any symptoms of urgency or loss of bowels/wind? This is what they should be concerned about.

Don’t want to scare you but you need to push to see a consultant and also demand that you have follow up.
Ie endoanal scan, anal manometry to assess what damage has been done to your spincter if they are quoting fourth.

All tissue will heal but if it wasn’t repaired at the time, the outcome of the actual damage done to your anal spincter muscle is usually bleak.

By all means as mentioned before, join Birth Tear Support (severe birth tears) on Facebook. Lovley group with over 900 people with abundance knowledge on this topic. I’m in the group and it’s helped me no end! Lots of advice and answers for you on there where people have been in same situation.

Feel free to private DM me if you wish.

Oh by the way, the doctors are most likely brushing over the clitoral and labia tear as although very awful for you, once healed although maybe unsightly they shouldn’t cause major issues. You could have it refashioned to look neater if you like.

The perineum tear is the one you should be concerned about most, the other two will heal an something can be done about the look of it in sure. The perineal tear extended to your anal spincter complex in your bum which is what controls your continence. It’s a very severe tear and this is the one you need to push on them to resolve first.

I had a dehissed labial tear with my eldest 9y ago. They wouldn't resuture.
It healed open, looks like someone has been after me with a stanley knife and is uncomfortable to sit, particularly to sit on a bike.

The urogynae team plan to sort it out with what I suppose is a labioplasty when my family is complete.

Bloody sucks. Hugs.

Complain. Regardless of how good she is. This is your life. If nothing is done you will reflect on this a LOT differently after the initial newborn stage is over.

4th degree tear here.
Trust me when I say DO NOT leave this to heal itself. It’s not possible. I can’t believe they have done this to you.
I had immediate 2.5 hour surgery and almost a year later I am reading this in tears because I know the issues I Am STILL having.

I know you are worried about the clitoral and labial tear the most. As upsetting as they are, the tear into the anal sphincter is the one to worry about. You do not want to have to be dealing with urinary and fecal incontinence in the future. Or prolapses.

Go private if you can and don’t give up. You only get one body.
How dare they treat you how they have. This is negligence and they should be sued.

Be kind to yourself x

You have been so badly let down. I can't imagine how hard it must be to look after a newborn after everything you've been through and when you're still in so much pain.

Please put your health before this midwife's reputation. She didn't do her job properly and it's ok for you to say that. Especially if it saves someone else going through what you are now.

Kick, scream, threaten, do whatever it takes to see the right people and get proper treatment. This needs resolving now, not down the line when you've suffered irreparable damage.

I've had 2 c sections and they were grim, but I'm truly shocked by your experience. I genuinely wish you all the best.