Moisture-associated skin damage during labour

We often encounter cases where the consequences of poor care during childbirth lead to injuries that could have been prevented with proper attention and timely intervention. One injury that is frequently overlooked is moisture-associated skin damage (MASD). This occurs when skin is exposed to excessive moisture for prolonged periods, leading to the softening, breakdown, or irritation of the skin’s outer layer.  In this article, I will explore the causes and consequences of MASD during labour, how it may be linked to medical negligence, and how mothers can seek justice if negligence is found.

Common causes of moisture-associated skin damage during labour

There are several key factors that can contribute to MASD for mothers, some of which are preventable:

1. Prolonged exposure to fluid or wetness: In cases where the waters break or there’s significant leakage of amniotic fluid, the mother’s skin is continuously exposed to fluid.
2. Prolonged labour: During a long and difficult labour there may be exposure to moisture for an extended period. Women may also be confined to a bed or medical equipment for long periods, increasing the risk of skin breakdown.
3. Use of invasive procedures: The use of catheters, intravenous lines, and other medical instruments like forceps, vacuum extractors, or episiotomies can cause moisture accumulation and friction on the skin.
4. Inadequate post-delivery care: After childbirth, mothers often experience sweating, discharge, and the presence of bodily fluids.

These factors can, if not managed properly, lead to MASD. Skin becomes vulnerable to damage, which can include redness, blistering, maceration, and, in severe cases, ulcers. These conditions may worsen if not promptly addressed, leading to chronic pain, scarring, and, in rare instances, infection.

The consequences of moisture-associated skin damage for mothers

While MASD may seem like a minor issue at first, the consequences can be serious if it’s not properly managed. Some of the potential consequences for mothers include:

• Skin irritation, redness and rashes which can be painful
• Infections leading to prolonged recovery times, additional medical treatment, and, in severe cases, sepsis.
• Delayed healing of perineal tears or episiotomies
• Ongoing discomfort and pain when sitting or trying to mobilise
• In severe cases, permanent scarring which can be both physically and emotionally distressing, especially for new mothers who are dealing with the challenges of postpartum recovery.
• Psychological harm as the visible effects of skin damage, such as irritation, rashes, or scarring, can affect a mother’s self-esteem and body image.

Medical negligence and moisture-associated skin damage in mothers

While some moisture-related skin damage is inevitable during childbirth, healthcare professionals have a duty to minimise the risk by providing appropriate care and timely interventions. When this duty of care is not met, it can lead to medical negligence claims. Examples of negligence include: –

1. Failure to monitor and manage moisture: Medical staff should be vigilant in monitoring the patient’s skin, particularly in areas most prone to MASD. If skin damage occurs from moisture accumulation and no steps are taken to prevent it, this could be considered negligent.
2. Improper use of medical devices: Invasive devices, such as catheters, should be placed and maintained with proper attention to hygiene and moisture control. Failure to ensure that moisture doesn’t accumulate under these devices can lead to skin damage. The use of obstetric devices such as forceps or vacuum extraction, if not handled carefully, can also result in skin damage.
3. Failure to reposition the patient: Extended periods in one position can result in both pressure injuries and MASD. It is the responsibility of healthcare staff to reposition the patient regularly, especially when they are immobilised.
4. Failure to dry or clean the skin after birth: After delivery, it is essential that the mother’s skin, especially in sensitive areas, be gently dried and cleaned.
5. Lack of appropriate skin care protocols: Healthcare providers should be familiar with the recommended protocols for managing moisture, including the use of barrier creams, regular cleaning, and prompt changes of any soiled clothing or bedding.
6. Delayed recognition of skin damage: In some cases, the damage from moisture exposure may not be immediately obvious. Delayed recognition and subsequent failure to address it may contribute to further injury.
7. Inadequate wound care following episiotomy or tear: For mothers who undergo an episiotomy or suffer a tear, adequate wound care is crucial to prevent complications. If moisture is not managed properly in the perineal area, it can delay the healing of these wounds.

Seeking compensation for moisture-associated skin damage

If you suspect that medical negligence led to your moisture-induced skin injury during childbirth, seeking legal advice from an experienced medical negligence lawyer is crucial. They can help ensure that your rights are protected, and if necessary, secure the compensation you deserve for the pain and suffering caused by preventable injury.