Janet N., 20

Janet comes from a family of five siblings and lives with her mother, who relies solely on casual labor to provide for the family, often managing only one meal a day. They reside in a mud-walled house in a severely run-down condition, located in a remote and densely populated rural area where most residents live in deep poverty. Janet’s father abandoned their family, leaving her mother as the sole provider. Janet arrived at the health facility complaining of backache, headache, and lower abdominal pain. Upon assessment, she was found to be in the second stage of labor and sustained a third-degree perineal tear during delivery. This is a critical obstetric emergency involving injury to the anal sphincter muscles, which, if not managed appropriately, can lead to severe complications such as obstetric fistula.

Janet presented to the health facility with complaints of severe backache, abdominal pain, and headache. She was promptly received in the maternity unit and transferred to the labor room for further assessment and care. Upon examination, Janet was found to be in the second stage of labor. She subsequently had a spontaneous vaginal delivery (SVD). During delivery, she sustained a third-degree perineal tear, which required immediate repair to prevent excessive blood loss and to restore the integrity of the perineum. Janet received appropriate treatment, including stitching of the tear, pain management, and other supportive care to ensure proper healing and recovery. She was closely monitored during her hospital stay and, once stable, she was discharged home in good condition.

If the condition could have not been managed in the facility by health professional it could have lead to complications;pain, difficulty with urination, and potential long-term issues like dyspareunia (painful intercourse) or, sometimes cases, fecal incontinence/ fistula.