ACC policy excludes perineal tears
I woke in the night remembering my own birthing tears and feeling for women in the long process of physical and psychological healing required after such an injury. This was stirred by an RNZ article by Anusha Bradley outlining the change in ACC’s policy on perineal tears. Prior to June 2020 the most frequently occurring birthing injury was tearing of the perineal and the number of perineal tear claims had increased year on year. Bradley says that after a review of policy ACC's chief clinical officer Dr John Robson explains "ACC can cover perineal tears that are the result of treatment, or the failure to provide treatment (a treatment injury). However, most perineal tears are not caused by treatment but by the birthing process and would be addressed in the normal course of care provided by the health system." Since changing the policy in July last year “less than four” claims for birthing tears have been accepted, the exact figure was not released. My own experience of a type 2 perineal tear and subsequent loss of pelvic floor structure has me deeply feeling for the women who experience type 3 and 4 tears and the trauma and life changes that potentially follow.
It is easy to jump to the conclusion this is a case of another group of men making decisions about women’s bodies. The article does point out the people involved in making the decision included “obstetricians, academics and midwives”, presumably some of these were women, but it does not conclude that all the people who made the decision agreed with the decision. I wondered if men experienced the same injury would this policy have changed? I can’t think of a similar natural event going wrong that a man might experience. One can trip over on the street, smash a knee and be covered with care, treatment, and financial support for life. On reading the government website on rape, which all gender can experience, the policy states “If you suffer an injury as a result of a crime, ACC may be able to help pay some of your costs” (http://www.victimsinfo.govt.nz/support-and-services/financial-assistance/accident-compensation-acc/) On the same site it says “ACC is a ‘no fault’ scheme. This means you can apply for help whether your injury was caused by something you did (as long as you didn’t intentionally injure yourself), or someone else’s action”. I find it hard to see how ACC can argue giving birth is not “something you did”, or a child exiting the vagina and the anus is not “someone else’s action”.
I wish I had a solution but the machine we live in is big. What I can do is offer perineal scar remediation. This helps soften scars that have fully healed and can bring sensation to areas of numbness.
Note: image from RNZ article Women struggle for treatment as ACC changes policy on perineal tears.