Missed fourth-degree tear diagnosis leads to woman undergoing colostomy days after birth of her first child

A 30-year-old woman, who we have called Olivia to protect her identity, gave birth at Princess Royal Hospital (University Hospitals Sussex NHS Foundation Trust) on 15 August 2021, six days after her due date. The pregnancy had been deemed low risk and was uneventful. Olivia delivered her baby within approximately 4 hours of her waters breaking earlier that day. After her delivery, Olivia’s perineum was examined, and a second-degree tear was found which was repaired using synthetic suture material.  

Over the next 48 hours, Olivia suffered heavy bleeding and passed foul smelling clots when she went to the toilet. Olivia raised concerns about the symptoms she was experiencing and was prescribed antibiotics and had an emergency blood transfusion.  

On 18 August 2021, due to ongoing symptoms, during an examination under anaesthesia, Olivia’s doctor identified that the tear had been misdiagnosed, and she actually had a fourth-degree tear. A fourth-degree tear is the most severe type of tear that can be sustained from childbirth and needs to be repaired with surgery. A rectovaginal fistula was also found.  

Olivia was transferred to Sussex County Hospital for surgery and had a loop colostomy six days after the birth of her baby. This operation redirects the colon to an artificial opening in the abdomen (the stoma). When Olivia was told that she would need a colostomy, she was understandably very distressed.  

After having the stoma, Olivia found it hard to look after, play and interact with her baby as she was worried about damaging the stoma. She was also unable to return to work as planned and had to extend her maternity leave and having to return to work part-time.  

As a result of the misdiagnosis and delayed treatment, Olivia is left with debilitating symptoms including frequent faecal urgency, difficulties with toileting and sexual dysfunction. She has also developed clinical Post-Traumatic Stress Disorder, which continues to have a significant impact on her day-to-day life, affecting her performance at work and her relationships with friends and family.

Oliva feels that due to her injuries suffered in childbirth, she was unable to spend as much time with her baby as she would have wanted in his early months.

In a legal claim against University Hospitals Sussex NHS Foundation Trust, Olivia’s solicitors, Suzanne White and Camilla Browne argued that had the fourth-degree tear been diagnosed during delivery, it would have been repaired with an operation immediately, no fistula would have developed, and a colostomy would not have been needed. Olivia would have been able to recover within six weeks.  

Following her delivery, Olivia received extensive support from MASIC, a specialist charity supporting women who suffer from life-changing birth injuries. We at Leigh Day are extremely grateful for MASIC’s input and ongoing assistance provided to our client during this difficult time. 

The University Hospitals Sussex NHS Foundation Trust admitted liability and settled the claim settled for £500,000 in May 2025.

Olivia said:  

“I cannot thank the team at Leigh Day who worked on my case enough. Throughout the whole process they were incredibly supportive to myself and my family. I am so pleased we reached a settlement, so I can move on from what was a very difficult time in my life.

“I will now be able to get further treatment for my symptoms in the future.  I do hope that the Trust will take learnings from my case and help prevent other women going through similar experiences. I would also like to thank the charity, MASIC, for the support they also gave me.”

Partner and head of the medical negligence department, Suzanne White, said:

“Again and again we are seeing these injuries in young pregnant women. It has the most enduring and distressing impact on mothers, their babies and their families. Consistently, we find in these cases women are not listened to throughout their maternity and postnatal care, resulting in these terrible injuries being diagnosed too late.  

“The admission of liability and compensation on this case can be seen as justice for Olivia but this does not change her life-altering injuries.”

Medical negligence solicitor, Camilla Browne, said:  

“It was deeply saddening to see how this missed diagnosis of Olivia’s fourth-degree tear has impacted such a young mother and prevented her from being able to enjoy those first few months with her firstborn child.  

“Perineal injuries seriously affect a person’s everyday life and relationships. I am pleased that we have been able to obtain a settlement for our client that acknowledges the severity of her experience and injuries. I hope this settlement provides her with the reassurance that she will have access to the support, treatment, and advice she needs moving forward, enabling her to begin rebuilding her life.”

Leigh Day worked closely with Sophie Beesley of Old Square Chambers to successfully conclude this case.