Maternal Birth Injuries – What We Must Talk About
Understanding injury, recovery and your rights after giving birth
A Quiet Pain Many Mothers Carry
You had a baby. It should have been one of the happiest days of your life.
Yet you’re left with pain when sitting, leaking wind or stool, feeling disconnected from your body, or unsure what really happened.
You may have Googled: “leaking stool after birth”, “pain months after episiotomy”, “why can’t I control wind after baby”.
You’re not alone — and you deserve answers.
What We Mean by Maternal Birth Injury
In this article we focus on injuries to the mother that can happen during labour, delivery or the immediate postpartum period. These include:
Severe perineal tears (third- or fourth-degree)
Poor repair of such tears
Inadequate recognition or follow-up of injuries
Birth trauma (physical + psychological)
These injuries can lead to long-term physical, emotional or social problems.
How Common Are These Injuries?
Here are some key facts:
According to the Australian Institute of Health and Welfare (AIHW), in 2023 about 2.7 per 100 vaginal births had a third or fourth degree perineal laceration. AIHW+1
In NSW in 2022 there were 1,446 third degree tears and 67 fourth degree tears among mothers who gave birth vaginally. NSW Health+1
The Australian College of Midwives (ACM) notes that one in three women in Australia report birth trauma (which may include physical injury) and one in ten report what is described as obstetric violence. RACGP+1
These numbers show the injuries are not rare — and significant enough to require attention.
A Specific Scenario: How It Could Happen
Let’s walk through a detailed scenario to help you see how things might go wrong.
Scenario: “Emily’s Birth”
Emily, aged 28, is having her first baby in a public hospital in NSW. Because it’s her first delivery, labour is long and the baby is large (estimated > 4 kg). After many hours of pushing, the care team decide to use forceps to assist the birth.
Emily is told an episiotomy may be needed but she is not given a detailed explanation of all risks (such as third/fourth degree tears or long-term pelvic-floor damage). During delivery, her perineum tears deeply but this is not clearly identified in the operating theatre records.
She is discharged home. At her 6-week check she mentions leaking wind and stool occasionally, but is told “this is normal after birth”.
Months later, she still has incontinence, pain during sex, and difficulty sitting. A specialist tells her she had a fourth-degree tear that was not properly repaired and that’s why she has ongoing issues.
She realises that if the tear had been recognised, repaired properly and followed up, her outcome could have been better.
Key moments in this scenario where things could have been different:
Risk factors (first birth, large baby, instrument use) not clearly discussed or managed.
Deep tear (third/fourth) not identified or documented.
Repair not done in optimal conditions or by experienced clinician.
Follow-up and postnatal support (pelvic-floor physiotherapy, continence clinic) not provided.
Evaluation of ongoing symptoms delayed or dismissed.
As a lawyer I see exactly these kinds of narratives repeatedly. The issue isn’t simply that the injury occurred – it is often how the system responded (or failed to respond) that causes the long-term harm.
What Causes These Maternal Injuries? Risk-Factors & Care Issues
Risk Factors
Research tells us the following raise the risk of severe tears or birth injuries:
First vaginal birth (primipara) AJOG+1
Use of instruments (forceps or vacuum) ACSQHC+1
Large baby (macrosomia) or prolonged second stage of labour ACSQHC+1
Episiotomy (surgical cut) – some studies show higher risk when episiotomy used indiscriminately. healthstats.nsw.gov.au+1
Public hospital births compared to private in some data sets AIHW+1
Care / System Issues That Make Injury Worse
From a patient safety and legal standpoint, the following issues often appear:
Lack of clear consent: Mothers not fully informed of risk of severe tear or of episiotomy vs. natural tear.
Poor documentation: The degree of tear not properly recorded; repair notes missing or unclear.
Delayed recognition: Symptoms like incontinence, pain or sexual dysfunction dismissed as “just after having a baby”.
Inadequate follow-up: No referral to pelvic-floor physiotherapist or continence specialist; no support for physical rehabilitation.
Under-resourced maternity services: The Select Committee on Birth Trauma found systemic issues in NSW maternity care. Parliament of NSW+1
These care failures can lead to lifelong problems — and may form part of a medical negligence claim.
Why Does This Matter? The Impact on Mothers
When severe maternal birth injuries happen and are not managed appropriately, the consequences can be profound:
Physical: Chronic pain, incontinence of wind/stool, difficulty with sexual intercourse, prolapse, pelvic-floor weakness.
Emotional / Psychological: Loss of confidence, fear of future pregnancy, post-traumatic stress, shame. The inquiry found birth trauma is ‘unacceptable’ and often avoidable. ABC+1
Social / Work / Life: Time off work, cost of specialist treatment, strain on relationships, altered body image.
Legal / Rights: These outcomes raise questions about informed consent, standard of care and whether legal remedy is available.
Understanding that the injury is not simply a “normal part of birth” is crucial. When care is sub-standard, the mother should know her rights and options.
When Could You Have a Compensation Claim? (What to Watch For)
As a NSW lawyer I explain this carefully: having an injury does not always mean you have a claim. But you may have one if certain factors apply.
What Generally Must Be Proved
Under NSW law (Civil Liability Act 2002 (NSW), s 5O), to succeed in a medical negligence claim you generally need to show:
A duty of care existed (yes, the hospital/maternity team owed you care)
The care provided was below the standard of a reasonably competent practitioner.
That breach caused your injury (causation) and you suffered loss (damage).
What Might Suggest a Claim in Maternal Birth Injury Cases
You might want to consider getting legal advice if you recognise one or more of the following:
A third- or fourth-degree tear occurred and was not clearly documented or repaired.
You were not informed of the risk of such a tear, or the option of episiotomy vs. tear risk.
You have ongoing symptoms (incontinence, pain, sexual problems) that were dismissed or not followed up.
You think the repair was done hastily, or you were not referred for pelvic-floor rehab.
The hospital’s systems were involved (e.g., understaffing, lack of continuity of care) and this may have contributed to what happened.
Why Legal Help Can Be Important
A lawyer experienced in birth injury cases can help you:
Obtain your full medical records (labour, repair, postnatal)
Arrange an independent obstetric‐or‐gynaecology expert to assess whether the standard of care was met
Assess how your injury has affected your life (work, relationships, health)
Explain possible time limits – in NSW you have three years typically from when you knew you had the injury to start a claim, though special rules apply.
Provide support so you’re not facing this alone.
It’s not about blame alone — it’s about clarity, fairness and ensuring future mothers receive better care. The recent inquiry into birth trauma in NSW said these injuries were “distressing and unacceptable”. Parliament of NSW+1
Tips & Tricks for Recovery, Support and Validation
Physical Recovery
Seek referral to a pelvic-floor physiotherapist as soon as possible. Skilled physiotherapy can improve outcomes even years after injury.
Consider a continence clinic or colorectal specialist if you’re leaking stool or wind.
Use warm compresses, perineal massage in antenatal period, and good birth positioning may reduce risk — evidence supports this. ACSQHC+1
Maintain good general health (nutrition, exercise, weight management) which supports healing.
Emotional & Mental Recovery
Acknowledge your experience: you may feel grief for the birth you expected vs the one you had.
Join support groups (such as the Australasian Birth Trauma Association) where other women share similar stories — knowing you’re not alone helps.
Talk to a counsellor or psychologist experienced in birth trauma — physical injury and emotional trauma often go hand in hand.
Keep a journal of symptoms and how you feel day-to-day — this can help in both recovery and, if relevant, later legal review.
Practical & Legal-Mindset Tips
Request your full maternity file (you have a legal right). Review what it says about tear degree, repair, postnatal care.
Keep a symptom log: when you leak, how often, impact on life/work/intimacy.
Ask your GP for a referral for specialist follow-up if your symptoms are ongoing.
If you are considering legal options, get advice early while records are fresh and memories clearer.
Consider your future pregnancy plans: if you want another child, ask specialists how your injury may affect that and what can be done.
Systemic Implications – Why Your Story Matters
From a legal and patient-safety perspective, individual maternal injuries shine a light on systemic issues:
The Select Committee on Birth Trauma in NSW found women’s stories revealed unacceptable gaps in care. Carroll & O'Dea Lawyers+1
The committee’s 43 recommendations (May 2024) included trauma-informed training, better midwifery continuity, improved physical and mental postnatal care. Birth Trauma Australia+1
These reforms show that injuries like yours are not just “bad luck” — they often reflect broader issues: staffing levels, continuity of carer, informed consent, post-natal follow-up.
As a lawyer I see that when one mother speaks up, it contributes to change: better protocols, better training, better care for women yet to give birth.
Final Reflection: Your Next Step
If you are reading this and feel something wasn’t right with your birth — pain that never went away, leaking you never expected, or simply the feeling you weren’t heard — please know:
Your experience is valid.
There is nothing “wrong” with you for seeking help.
Recovery is possible with the right support.
You may have rights to compensation if your care was below standard.
You don’t have to navigate this alone.
As a lawyer who has helped many women in NSW with birth injury claims, I believe in both justice and healing. If you’d like a confidential discussion of your situation, feel free to reach out. Even if you don’t wish to claim, understanding your story, your body and your rights can help you reclaim your life.
