Complications from Episiotomy: What You Should Know
Many people think of an episiotomy as a fairly common part of the birth process, and it certainly has been in recent decades. A surgical incision used to enlarge the vaginal opening to ease delivery, most episiotomies are performed without incident. However, complications from episiotomy do occur, and can cast a shadow over a joyful day and the months or years that follow.
There are many legitimate reasons that an obstetrician might perform an episiotomy, including:
- the baby is in distress;
- the baby is in a breech presentation;
- the baby's shoulders are trapped, known as shoulder dystocia;
- labor is proceeding quickly and the perineum has not had time to stretch adequately;
- the baby's head is large; or
- forceps or vacuum-assisted delivery is needed.
Once routinely performed (as late as the 1970s, up to 60 percent of vaginal births involved an episiotomy), episiotomy rates have declined over the past decade or so. This decline is due, in large part, to a 2006 recommendation by the American College of Obstetricians and Gynecologists (ACOG). The recommendation noted that while episiotomies were performed in about a third of American births, precautionary use of the procedure did not improve outcomes for mother and child. As a result, the organization warned against liberal or routine use of the procedure. Some experts estimate that the procedure should be performed in less than ten percent of cases.
Since this recommendation issued, use of episiotomies has decreased significantly, but the procedure may still be performed more than necessary. That is a problem because injuries from an episiotomy can seriously affect a patient's quality of life.
Injuries and Complications from Episiotomy
When episiotomy is needed and performed correctly, it can prevent tearing of tissue and make delivery easier for mother and child. However, if the procedure is not indicated or is negligently performed, episiotomy can lengthen recovery time and cause a host of complications. These include bleeding, swelling, bruising, infection, extended healing time after the birth, painful scarring, deep tissue tears, sexual dysfunction, and incontinence.
There is another issue many women also experience when their doctor wants to perform an episiotomy: feeling pressured or forced into the procedure. Rarely is a woman more vulnerable than when she is at the point of giving birth. Some women have had episiotomies performed without their consent when the procedure was not necessary for their health or that of their baby. Others have felt bullied into consenting to the procedure. An unnecessary episiotomy performed without the mother's full consent can be traumatizing.
A California woman whose child's birth was video recorded repeatedly begged the obstetrician not to cut her. He did so anyway: twelve times, despite the fact that there were no medical indications for episiotomy. The case ultimately settled out of court, but was notable for the fact that the claim was characterized not only as medical malpractice, but as medical battery or obstetric violence.
When Episiotomy Equals Medical Malpractice
In order for an action to constitute medical malpractice, four elements must be present:
- a professional duty owed to the patient;
- a breach of that duty;
- injury caused by the breach; and
- damages resulting from that injury.
Medical malpractice can arise in an episiotomy case in a number of scenarios. The doctor-patient relationship creates a duty to act as a reasonable professional would in a similar situation. Performing an episiotomy when one is not medically called for, or performing a needed episiotomy without the proper level of care, could be a breach of that duty. Complications suffered as a result of the episiotomy constitute an injury from which damages will likely flow. Those damages could include bills for additional medical care or the cost of extra assistance at home during a complicated recovery. Performing an episiotomy without the patient giving her informed consent could also lead to a malpractice claim.
What should you do if you suffered complications from an episiotomy? It is worth having a consultation with an Oregon medical malpractice attorney. The simple fact that you had an episiotomy performed and a difficult recovery does not necessarily mean that medical malpractice took place. An ethical attorney can review the facts of your case with you and help you determine if you have a worthwhile claim. If you do, your attorney will guide you through the process of filing the claim and help you to pursue the compensation you may be entitled to.
If you have questions about episiotomy and medical malpractice, we invite you to contact our law office to schedule a complimentary consultation.
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The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.