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Birth injury (to the mother)

11-minute read

Key facts

  • Physical birth injury includes a variety of conditions usually affecting the perineum and pelvic floor.
  • Most risk factors are out of your control, but there are preventative measures and treatments available.
  • You may experience physical birth injury, emotional birth trauma, or both of these.
  • Support is available — speak to your doctor or midwife about how to prevent birth injuries, or if you've already given birth, discuss any concerns with a health professional.

What is birth injury?

Birth injuries are physical injuries experienced during childbirth. They can affect either the mother or the baby. In newborn babies, a birth injury (often called 'neonatal birth trauma') can include things, from bruising to a broken bone.

If you've given birth, injuries may range from tearing in the vaginal area, to damage the pelvic floor. Caesarean wounds can also be considered a physical birth injury.

Birth injuries in mothers typically fall into 2 main categories:

Injuries to the perineal area

Injuries to the pelvic floor

If after you give birth you notice symptoms such as pain in the vagina or perineum or going down your legs, changes to your bowel or bladder habits, or a heaviness or dragging sensation in your vagina, speak to your doctor or midwife early so they can help you manage the problem.

Symptoms of birth injury

Don't be afraid to ask questions as you may be the first to notice that something is not right.

Physical symptoms of birth injury may include:

You may also find there is a physical change to your vagina presenting as:

Physical trauma during birth can include:

Physical injuries due to birth injury require expert medical assessment and treatment.

Can physical birth injury impact me emotionally?

When you experience physical birth injury, you may also experience emotional or psychological distress related to what happened during the birth. This is known as psychological or emotional birth trauma. This can present as postnatal depression and/or anxiety, postpartum post-traumatic stress disorder or obsessive compulsive disorder.

Emotional birth trauma can also refer to how you, as the parent, feel after your baby is born. Sometimes the effects of birth trauma might first appear some time after you've given birth. Emotional birth trauma can continue long after the birth and many people don't seek support for months or even years. Some people think that they shouldn't be traumatised, but if your birth experience felt traumatic to you, then it was. You should seek help from your doctor as soon as possible.

There are many resources and professionals who can support your treatment and recovery from both physical birth injury and emotional birth trauma.

What are risk factors for birth injury?

If you suffer a birth injury, the cause was most likely something out of your control. Different birth injuries have different risk factors.

Some of the risk factors for birth injury include:

Can birth injury be prevented?

Although it's often not possible to prevent birth injury, there are some things you can do during pregnancy and labour to reduce your risk.

You will make decisions about your birth as part of a shared decision-making process between you and your doctor or midwife. Unless it is an emergency, your health team will provide you with an explanation of any intervention, as well as the risks and benefits to you and your baby, before you can give your informed consent.

Consider creating a birth plan and getting tips on preparing for labour and birth. Your birth plan is a written summary of your preferences for when you are in labour and giving birth. You can also share your birth plan with your health team, and speak to your midwife or doctor about which birth positions you'd prefer to try.

How is birth injury treated?

Some birth injuries are minor and may heal on their own — for example, a minor perineal tear or graze. Other injuries need treatment at the time, such as a deeper tear that needs stitches. You may also need some pain relief.

If you had a significant tear or damage to the muscles of the pelvic floor, treatment may include physiotherapy and exercises to strengthen your pelvic floor muscles. Some women may need to use pessaries in their vagina or surgery to repair a prolapse. Sometimes, signs of pelvic floor damage or prolapse are not detected and treated until much later.

What can help my recovery?

The best way to help your recovery will depend on the type of injury you have.

If you have third or fourth degree perineal tears, your doctors will prescribe antibiotics to prevent your wound from getting infected. You will also be recommended to take pain relief and stool softeners, so you don't need to strain to open your bowels (do a poo). You will often see a physiotherapist to discuss looking after your pelvic floor and when to start exercises before you go home.

When can I have sex again after birth?

When you start to have sex again is a personal decision. It might be some time before you want to have sex.

If you've had a birth injury, speak to your doctor about their recommendations. They will consider your specific circumstances, so let them know if you experience any ongoing pain.

What follow-up appointments should I have?

Follow-up appointments with your doctor or midwife are important, particularly as some symptoms can take time to either settle down, or show up. For example, they may want to see you a few weeks after delivery and then a few months later. Make sure you understand your follow up plan before you leave the hospital.

If you have had a birth injury, you may be at more risk of it happening again with your next baby. Your doctor will talk to you about your options for your next birth.

If you experience any ongoing symptoms, such as pelvic pain or bladder and bowel problems, you should see your doctor.

Resources and support

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