ABSTRACT
Up to 4% of women complain of faecal incontinence after childbirth and a larger number of incontinence of flatus. Most of these problems are short lived and improve with time. The strongest correlation is with instrumental vaginal delivery, but these complications can occur after any vaginal delivery and even after a caesarean section in labour. Only an elective pre-labour caesarean section is completely protective. The fact that the repair of an extended episiotomy or a third or fourth degree tear has not been successful is not, in itself, evidence that it has been carried out in a substandard fashion; however, the experience and seniority of the doctor involved needs to be fully scrutinised. Certainly, if it can be shown that the repair was inadequate, perhaps because the full extent of the damage was not recognised, then an action may be successful. Even then, a defence may be put, formally challenging the assumption that such repairs, even properly carried out, are always successful.
