If you had a serious tear during birth, you may have been told it was “common,” or that it would heal on its own. Some women hear that at the six-week check. Others don’t hear anything at all, and only realise months later that what they’re living with isn’t normal.
So it can be jarring to see the headlines coming out of the UK this year.
What’s happening in the UK
In 2026, two major UK reviews put maternity care under the spotlight. The Ockenden review of Nottingham University Hospitals found “long-standing and deeply embedded systemic failures” across maternity and neonatal care. A separate national investigation heard from more than 10,500 women and families about their experiences.
The data is hard to ignore. In England, serious perineal tears have risen to 31.1 per 1,000 births, up from 25 per 1,000 in 2020. Severe postpartum haemorrhage (blood loss of 1.5 litres or more) has climbed in a similar way, from 25.6 to 31.65 per 1,000 births.
The UK Health Minister didn’t soften it. He said there were “failings across the board” and that the culture was wrong.
These findings are about the UK system, and we need to be careful not to assume the same numbers apply here. But the stories behind them will sound familiar to many Australian women.
Australia has been having the same conversation
The 2024 NSW Parliamentary Inquiry into Birth Trauma heard from thousands of women. It found that around 28% of women experience birth trauma, and many described feeling dismissed, uninformed, or not listened to. A national survey of around 9,000 people found that 11% reported experiencing what’s described as obstetric violence.
Since then, the NSW Government has committed funding to maternity care, including $44.8 million to expand midwife-led continuity of care, 53 additional midwife positions in regional and remote areas, and training for clinicians in respectful maternity care. Antenatal education is also being improved.
Those are welcome steps, but there is still a long, long way to. Continuity of care, where you see the same midwife or small team throughout pregnancy and birth, is linked to better experiences and outcomes. Better education helps women understand their options before labour, not during it.
But reform looks forward. It’s about making future births safer. It doesn’t change what has already happened to the women who were injured before these changes arrived.
What is a serious perineal tear?
Let’s talk about this openly, because too many women are expected not to.
The perineum is the area between the vagina and the anus. Many women experience some tearing during a vaginal birth, and most minor tears heal well. Tears are graded by how deep they go:
- First and second degree tears involve the skin and muscle of the perineum.
- Third degree tears extend into the anal sphincter, the muscle that controls the bowel.
- Fourth degree tears go further, through the sphincter and into the lining of the bowel.
Third and fourth degree tears are often called obstetric anal sphincter injuries (“OASI”). When they’re recognised straight away and repaired properly by someone with the right expertise, many women recover well.
When they’re missed, poorly repaired or not followed up, the effects can be life-changing. Women describe ongoing pain, faecal or wind incontinence, urgency, difficulties with sex, and in some cases the need for further surgery. Many also carry anxiety, embarrassment and grief about how their body has changed.
These are not small things. And they’re not things you should have to manage in silence.
When a tear may involve negligence
Not every tear is anyone’s fault. Some happen despite excellent care, and it’s important to say that clearly.
But there are situations where a tear, or the harm that followed it, may have been preventable. Questions worth asking include:
- Were your risk factors identified? Things like a larger baby, a first vaginal birth, or a previous serious tear can increase risk. Were these discussed with you before labour?
- Were you properly informed? Were you told about the risks of instrumental delivery, like forceps, and given the chance to consider alternatives such as a caesarean?
- Was the tear properly assessed? After birth, a careful examination should identify the extent of any tear. A third or fourth degree tear misdiagnosed as a second degree tear can be missed entirely.
- Was it repaired by the right person? Serious tears generally need repair by an experienced clinician, usually a general or colo-rectal surgeon in appropriate conditions.
- Were your symptoms taken seriously afterwards? Many women report raising concerns about incontinence or pain and being told it would settle, when it needed investigation.
If any of these didn’t happen, you may have legal rights you haven’t yet explored.
“Isn’t this just part of giving birth?”
It’s one of the most common things we hear. Many women assume ongoing pain or incontinence is simply what happens after a baby. Some have been told so by health professionals. Others feel too embarrassed to raise it at all.
It isn’t something you should have to accept without answers. And you don’t need to have worked out whether anyone made a mistake before you talk to us. That’s our job. You just need to be willing to ask the question.
It’s also worth saying: asking questions about your care isn’t disloyal to the midwives or doctors who looked after you. Many women had caring staff and still experienced a failure in the system around them. Both things can be true.
What a claim can help with
If your injury was caused by a failure in your care, a compensation claim may help cover:
- Treatment costs, including specialist care, surgery and pelvic health physiotherapy
- Psychological support
- Income you’ve lost, or may lose in the future, because of your injury
- Help at home while you recover
- The pain and impact the injury has had on your life
Every situation is different, and we can’t predict any outcome without carefully reviewing your circumstances and records. But for many women with serious tears, the costs of ongoing care are significant, and it’s worth knowing whether you should be carrying them alone.
The emotional side of a serious tear
The physical symptoms are only part of the story. Many women with serious tears tell us about the silent effects: avoiding social outings in case they can’t get to a bathroom in time, feeling disconnected from their partner, or dreading the idea of another pregnancy. Some describe grief for the body they’ve lost and the birth they expected to have.
These feelings are common, and they’re valid. A good pelvic health team and psychological support can make a real difference, and those supports are worth seeking out whether or not you ever pursue a claim.
If a failure in your care contributed to your injury, the emotional impact is also something the law recognises. It forms part of what a claim can take into account, alongside the practical and financial costs.
Practical steps you can take now
Whatever you decide, a few simple things can help:
- See a specialist if you have ongoing symptoms. A pelvic health physiotherapist or a colorectal or urogynaecology specialist can assess what’s happening.
- Request your medical records from the hospital, including your birth notes.
- Write down what you remember, including what you were told about your tear and its repair.
- Keep track of costs and time away from work.
How we can help
Birth Injury Lawyers is the only Australian law firm specialising in claims for mothers injured during childbirth. We know perineal injury claims well, and we understand how personal and difficult they are to talk about.
Your case is led by Anthony Porthouse, an Accredited Specialist in Personal Injury Law with 36 years’ experience in medical negligence and hundreds of settlements across Australia.
We’ll be honest: these claims can be challenging. They involve careful review of your records and independent medical opinion. It can be hard to revisit what happened. But you won’t face it alone, and you won’t face surprise bills. We work on a no win, no fee basis with a clear, fixed fee agreed for each stage before we begin.
You’re allowed to ask
The UK is asking hard questions about its maternity care. NSW is starting to act on what women told the Birth Trauma Inquiry. Those are important changes.
You’re allowed to ask questions about your own care too. And you deserve clear, honest answers.
Find out if you have a claim — free, confidential consultation
This information is general in nature and does not constitute legal advice. Every case is unique. We encourage you to contact us directly to discuss your specific circumstances.
