Trust's poor monitoring caused traumatic experience for woman following childbirth

What happened

Mrs N went to the Trust to have her first child. The birth was difficult because her baby's shoulder got stuck, and so Mrs N had to have an incision (an episiotomy) to allow her baby to be born. The incision led to blood loss but staff repaired it. A consultant obstetrician inspected the repair and, following that, noticed a third degree tear that needed to be repaired in theatre. However, there was a delay as the only theatre was dealing with an emergency case. In the meantime, Mrs N was given antibiotics and was later taken to theatre. Mrs N suffered more blood loss during the procedure. She was transferred to the high dependency unit and was later discharged.

Mrs N complained that she suffered from bowel incontinence as a result of what happened and that, although she was later referred to specialists at the Trust, she has not been able to regain control of her bowel. She's now left with a lifetime disability. She said she was highly dependent on the help and support of family and friends and that a second pregnancy would be very difficult and could put her and the baby at considerable risk. She was also unable to work and lost her previously active lifestyle.

What we found

We partly upheld the complaint. We found that there was service failure but that this did not lead to the claimed injustice.

Following the birth of her baby, Mrs N was not adequately monitored, managed and treated. However, we did not consider that the delays she experienced could be linked to the outcome of incontinence. Our view was that this was more likely to be associated with straining when giving birth, leading to pudendal nerve neuropathy (damage to nerve located in the pelvis). Mrs N was recorded as straining for two hours and the recommended maximum is three hours.

Putting it right

The Trust told us that it had developed a standard operating procedure that addresses how postnatal women who require further treatment in theatre should be managed while awaiting transfer. This was to make sure that there were improvements in postnatal management, monitoring and recording.