A MUM who suffered a "traumatic" birth is still living in agony 15 years later.
Geeta Nayar sustained a third-degree perineal tear and nerve damage when her first child was "forcefully" delivered by forceps.
The now-46-year-old underwent surgery for her wounds, also known as an obstetric anal sphincter injury (OASI).
But the operation failed, and she soon started experiencing excruciating and debilitating symptoms.
Geeta, from North London, endured numerous other procedures, but a decade and a half later, she continues to battle intense pain, scar tissue and incontinence.
The medical negligence lawyer said: "I was left completely traumatised by the experience."
Geeta and her husband Ed, 49, were "overjoyed" when they discovered they were expecting a little girl.
"We’d painted the nursery bright yellow, and my birth plan had been meticulously prepared," she said.
"We were excited about what the future held."
And when the mother-to-be went into labour, everything seemed to be going as expected, with her "calm" midwife putting her at ease.
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But after several hours with little progress, things took a turn.
"I was exhausted with pain and there was a change of shift," Geeta said.
"It was at this point the situation started to deteriorate."
Concerned about her unborn daughter's safety, Geeta asked to be moved to theatre, but her requests were allegedly dismissed.
The situation then "deteriorated further" until there was "marked foetal distress".
"What followed can only be described as a nightmare," Geeta said.
"Panic ensued. There were several failed attempts at trying to deliver my daughter by a ventouse suction cup followed by an extremely forceful and traumatic forceps delivery.
"My daughter was born with deep cuts to her face and I sustained a tear involving the entire length of the external and internal anal sphincter, and nerve damage.
"Instead of holding and feeding my daughter, I was taken to theatre for several hours for an attempted repair.
"This unfortunately failed, and I suffered my first episode of incontinence the very next day."
I was left completely traumatised by the experience.
Geeta was discharged from hospital three days later.
However, once home, she claims she had no medical support and struggled to leave the house because of her injuries.
The new mum visited her GP several times, but it wasn't until months later that she was referred to a specialist perineal trauma unit.
Following tests, the full extent of her condition, including that her nerves had been damaged and her initial surgery had failed, was established.
Geeta has since undergone several procedures but still lives with her nightmare symptoms.
"I went from being a resilient, independent woman to needing significant help," she said.
"While my friends were meeting in the park and attending baby groups, I was barely able to leave the house.
"I struggled on, but, after several months the situation was dire.
"It was only when I finally saw a specialist several months later I was told for the first time how serious my injuries were.
"It was horrifying to hear, but also, a relief to finally understand why my symptoms were so severe and debilitating.
"Since then I have undergone further surgical repairs which have also failed, but I simply have had to adjust the way I live to cope."
MUM'S TRAUMA
Research from the birth injury charity The MASIC Foundation suggests around one in 20 first-time mums suffer an OASI during childbirth.
Further studies have revealed ethnicity plays a major part, with women of Asian heritage around six times more likely to sustain one than white women during natural delivery.
A shorter perineum less able to stretch during delivery is one theory as to why, Geeta said.
Inspired by her own ordeal, the parent now represents others affected by OASI in legal cases at the firm Irwin Mitchell.
Alongside the MASIC Foundation, she is also urging the NHS to introduce a seven-point plan to reduce birth injuries.
This would involve increased training, awareness for pregnant women as well as specialist clinics and psychological support.
"If you ask any woman whether she would want to be told of a risk factor that may affect her six times as much, I’m sure the answer would be a resounding yes," Geeta said.
"Had my ethnicity been taken into account and I’d been told of my greater risk of perineal injury as a South Asian woman having her first child, and the healthcare professionals whose care I was under knew of these risk factors, I strongly believe the outcome may have been different.
"What happened to me was despite being born in this country and having a sound knowledge of the medical system.
"Now imagine those difficulties being compounded by having a poor grasp of the language, or living in a community where talk of issues such as incontinence is completely taboo.
"The cultural, language and structural barriers to understanding and accessing adequate care can be insurmountable."
She added: "It's taken me many years to come to terms with and find the courage to speak about what happened to me.
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"The issue of birth trauma is still relatively taboo, but I hope by speaking out I can help other women.
"While it’s too late for me and I’ll always be affected by what I’ve been through, it’s vital that other women are aware of the risks of OASI injuries in childbirth so they can make informed decisions about their care and potentially avoid years of trauma, surgery and loss."
What is an Obstetric Anal Sphincter Injury (OASI)?
AN Obstetric Anal Sphincter Injury (OASI) can extend down from the vaginal wall and backwards through the perineum to the muscle that controls the back passage (anal sphincter).
It occurs due to the tearing of tissues during childbirth.
While it is impossible to predict who will have one, certain factors increase the chances of it happening. This includes:
- First baby
- Ethnicity (Asian and Black)
- Shoulder Dystocia (when one of your baby’s shoulders becomes stuck behind the pubic bone
- during delivery)
- Large baby
- The direction the baby is facing at birth
- Induction of Labour
- Epidural
- Pushing for a long time
- Assisted delivery
The reported rate of OASI has tripled from 1.8 per cent to 5.9 per cent from 2000 to 2012 in England.
The overall incidence in the UK is 2.9 per cent, with a rate of 6.1 per cent in first time mothers compared with 1.7 per cent in those who have had babies before.
An OASI is usually repaired in theatre, with doctors stitching muscles back together.
Pain relief is then normally prescribed, as well as a course of antibiotics.
Some people experience long-term problems, such as needing to rush to the toilet and urine and bowel leakage.
Source: Liverpool Women's NHS Foundation Trust
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