Ms S gave birth to her son by ventouse delivery at Nottingham City Hospital.  An episiotomy was performed due to the nature of the delivery.  She was told that the stitching following the cut had gone well and the skin had met correctly, but was not given any further information about the procedure.

Extreme pain following negligent episiotomy

The following day, Ms S told nurses that she was in pain around the perineum and asked for further pain relief, but she was told it was normal.  Ms S and her baby were discharged on that day and no further examination of the perineum was undertaken.

Ms S was visited by the community midwife the next day.  She examined the perineum, and was shocked to see swelling and soreness.  She asked if anyone had checked the area before Ms S had left hospital and was surprised to hear that they hadn’t and that Ms S had been discharged without examination.  The midwife told Ms S that the area would need to be closely monitored.  She also told her that the pain relief that had been administered by the hospital – codeine – was not appropriate because Ms S was breast feeding and small amounts of the drug can pass to the baby.  The midwife called Ms S’s GP, who confirmed that codeine should not be taken and advised ibuprofen or paracetamol.

Ms S was in so much pain that she could hardly sit, stand, lie down or move about comfortably.  Sadly, her partner had to carry out most of her son’s care and of course she felt that she was really missing out on that.  She was also worried about bonding.

Visit to A & E says pain due to healing episiotomy

A few days later, a second community midwife examined Ms S and was again shocked.  She said it was possible that the Ms S had a haematoma as there were clearly 2 lumps visible around the episiotomy site.  The midwife arranged to visit the next day, but Ms S was in so much pain during the night that she had to attend hospital the following day instead.

Whilst in hospital a midwife examined Ms S and said that it was likely that she would need a further operation, and that was confirmed by a doctor, but a consultant said that the cut had started to heal and surgery would interrupt the healing process.  She suggested that the pain was due to the stiches tightening and preparing to snap – and not due to the area having been stitched incorrectly.  Ms S was prescribed stronger pain killers and antibiotics as a precaution.  Ms S was very upset by the whole situation, and was made to feel that she needed to “just get on with it”.

Ms S continued to struggle and found the pain so severe that she needed help looking after her baby as well as all the other household matters.

Further operation as hospital agrees episiotomy not stitched properly

Around 3 weeks later, Ms S attended the antenatal clinic at Nottingham City Hospital.  The doctor there agreed with Ms S’s claim that the perineum area had not been stitched properly and referred her to a specialist consultant.

Nervous about having surgery, but pleased that something was going to be done about the pain, Ms S underwent surgery around 3 months after the birth of her son.  There was a lot of scar tissue after this operation and the skin was still not completely aligned properly.  Ms S was told she would have to have another operation.

Ms S found the whole ordeal emotional and distressing.  Not only had she suffered a lot of pain, it had ruined her experience of being a new parent.  Had her partner not been so supportive, Ms S feels that their relationship may have been severely affected.   The physical and emotional effect that the ordeal had on Ms S meant that she gave birth to her second child by C-section, which she would not have chosen had she not suffered so much following the birth of her first child.

Nikki claims compensation for negligent treatment

Ms S felt that the treatment she had received during and after her first labour was negligent and contacted Graysons to see if she could gain redress. took up her case and contacted Nottingham University Hospitals NHS claiming that:

• The performance of the episiotomy was substandard and/or incorrect.  No reasonable or competent practitioner in obstetrics would have performed the episiotomy in the way it was done.
• The stitching of the perineum was substandard and would have been evident but the obstetrician failed to notice it.
• No examination was undertaken before Ms S was discharged
• Ms S was not referred for a more senior opinion despite community midwives noting swelling and tenderness.
• Community midwives failed to examine the perineum on further occasions
• The overall care provided was substandard.

Nottingham University Hospitals NHS Trust denied liability throughout and Nikki had to issue proceedings.  A trial was listed for August this year.  However, Nikki was able to negotiate a settlement of £9,900 with the hospital just a couple of weeks before the case went to court.

Ms S was delighted with the outcome, saying

“Nikki was personable, approachable, helpful professional and excellent at explaining things so that legal talk made sense to me.  She advised every step of the way and I couldn’t have been happier.  She reassured me as the court date approached and was always confident and fully supportive.  Although I hope never to be in the situation again, I would use Nikki in the future if needed.”

You can find out more about making obstetrics and gynaecological claims on our web site.