You had a birth plan to have your child naturally, without medication, a c-section, or an episiotomy. But life does not as always work out the way we plan, especially when it comes to the delicate and highly complex process of childbirth. Doctors often decide what is best for you and your baby based on the minute-by-minute developments of labor and delivery. Still, you want to know if that painful episiotomy was necessary, and if you suffered complications, you are likely plagued by the question: was it the doctor’s fault? Complications from episiotomy procedures range from pain to infection, excessive blood loss, and incontinence. Despite the favorable recovery rates among most mothers, others experience long-term pain and discomfort, with the potential for additional complications due to improper suturing of the episiotomy site. Physician errors while performing these procedures or subsequently suturing episiotomies occur, with potentially devastating consequences for women.
If you suspect that negligence played a role in your ongoing issues from an episiotomy, it is advisable to further explore your potential legal claim for medical malpractice. You may be able to recover compensation for past and future medical expenses, corrective procedures, lost income, and the undoubted pain and suffering caused by your injuries. Contact our team to speak with a knowledgeable New Jersey birth injury and medical malpractice attorney who will listen to the circumstances of your unique case, further investigate possible substandard healthcare services, and pursue compensation from the one or more negligent parties who contributed to your episiotomy complications. You can fill out our convenient online form or call (866)-708-8617 now for a free consultation.
What Happens in an Episiotomy?
To facilitate delivery and prevent tissue ruptures during the pushing phase of labor, an obstetrician may use surgical scissors or a scalpel to make an incision to the perineum, the tissue between the opening of the vagina and the anus, a procedure known as an episiotomy. The incision essentially allows for a larger opening for the baby. An episiotomy is performed after the baby’s head has stretched the vaginal opening a few centimeters and the doctor has injected a pudental block (local anesthetic) at the surgical site to make the process painless. The physician may make a midline incision vertically or a mediolateral incision at an angle. A midline cut, though easier to fix, risks tearing into the anus. A mediolateral cut is less risky for an extended tear but is more difficult to heal from and repair. After delivery, the incision is sutured and the stitches eventually dissolve.
When an Episiotomy may be Recommended
Typically, when the crown of the baby’s head is visible, the doctor manipulates the head to ease it out, with the shoulders and rest of the body easily following. However, while the vaginal tissues do stretch to allow a baby’s delivery, sometimes they do not stretch sufficiently in enough time. This often prompts an episiotomy recommendation. Episiotomy was previously a routine procedure, but they are now discouraged by leading medical authorities and used only when necessary. In fact, the American College of Obstetricians and Gynecologists over the last 14 years has urged doctors to perform fewer episiotomies. The prevailing presumption was that a straight surgical cut would heal better and preserve the pelvic floor tissue more than a tear. That theory is now debunked and episiotomies are solely recommended when the baby needs to be delivered quickly based on a specific set of conditions.
The following may lead your doctor to recommend an episiotomy:
- The baby is unusually large
- Preterm birth
- The baby is stuck behind the pelvic bone (known as shoulder dystocia)
- Abnormal position/birth presentation, such as breech (feet first) position
- The baby is oxygen deprived and in distress
- Abnormal fetal heart rate
- Prolonged pushing in labor
- The use of labor assistance devices, such as forceps or vacuum extractors, become necessary
- Delivering twins
Potential Complications from Episiotomy Procedures
Aside from the pain while healing, an episiotomy, like all surgical incisions, raises the potential for infection. Signs of infection include: intensifying pain, fever, and wound discharge. For some women, the incision site remains painful long after delivery, interfering with their sex life and thus, often psychologically wounding a woman’s body image and personal life. Other complications include bleeding, bruising and swelling at the incision site. If a midline episiotomy extends into the anal region, a recovering woman may have fecal incontinence, at a minimum, and require major surgical repair in the worst cases. In fact, tears to the rectal sphincter are four-times more likely with an episiotomy than without one. Sometimes the pain and incontinence last long after birth.
The leading risks and complications that may result from episiotomies include:
- Severe pain
- Bleeding and blood loss
- Torn anal sphincter muscle and rectal tissues, which can lead to leaking stool and gas
- Pain during sexual intercourse
- Hematoma: blood pooling in the area
- Swelling and tenderness
In addition, incorrectly stitching the episiotomy site or improperly gauging the location or length can lead to significant pain and other problems. These errors may even require surgical revision and repair.
Can You Avoid an Episiotomy?
So how can you avoid an episiotomy? The doctor can perform vaginal massage, stretching the opening during labor, or the patient can stretch the tissue before the onset of labor. Good nutrition aids in maintaining supple, stretchable skin, and Kegels (exercises) keep the pelvic floor strong to assist pushing. During labor, warm compresses may prove beneficial for the labor process. Also, medical professionals may advise laboring off of the back and instead sitting up, squatting, or laying on your side, to lessen the chances for a necessary episiotomy.
Episiotomies and Medical Malpractice
Taking steps to avoid episiotomy, as well as respecting a woman’s birth plan wishes, must be important physician priorities. The procedure is largely frowned upon unless necessary because too often the risks to the mother’s health do not equal the necessity for the procedure. Hospitals with high episiotomy rates, comprising over 5% of all births, raise questions of necessity. Is the doctor following old habits or motivated by convenience more than a real danger to the mother or child? What if a physician fails to inform the patient about potential risks and alternatives to episiotomy? Even worse, what if they make a mistake while performing a surgical cut during the labor and delivery process or suturing the site after the procedure is complete? These and other questions are worth discussing with an experienced medical malpractice attorney, who can evaluate your individual situation and determine if you may have grounds for a lawsuit.
Contact a New Jersey Episiotomy Malpractice Lawyer Today
If your provider did not perform to the acceptable professional standards of other medical providers given your birth situation, and you or your child suffered injury as a result, we encourage you to contact us to discuss your case. If birth-related negligence caused you preventable harm, you may be eligible to recover medical costs, lost income, and pain and suffering damages. Our lawyers have a wealth of knowledge and particular experience in this area of law and we are here to help. Contact us at (866)-708-8617 for a free case review from a birth injury attorney in New Jersey near you.
- Episiotomy: When it’s needed, when it’s not, MayoClinic
- Episiotomy, Stanford Children’s Health
- Episiotomy Procedures – Advantages & Complications, American Pregnancy Association
- Episiotomy vs. Tearing: Moms Cut in Childbirth Despite Guidelines, USA Today