The Dreaded Third Degree Tear…
(March 2017) On supporting a woman in labour who subsequently sustained a third degree tear, and the experience of significant feelings of guilt and hand-wringing, I have been reflecting on my role in the possible prevention of such a degree of trauma and then the support given to women following repair as well as the outlook for morbidity. According to the Royal College of Obstetricians and Gynaecologists (RCOG), a third degree tear can be defined as “a tear that involves the muscle that controls the anus (the anal sphincter)” and affects on average 3% of women giving birth; broken down this equates to approximately 6% of primiparous women and 2% of multiparous women although the risk increases to 5-7% if they have sustained a previous third degree tear (2015). Clements (2001) takes a more conservative stance, estimating third and fourth degree tears to be more in the region of 1-2%. Regardless of the percentile incidence, the reality is that the long term implications of su...