How to Treat: Maternal birth injuries - assessment answers

1. List three injuries now covered by ACC funding as maternal birth injuries.

• Anterior vaginal wall prolapse, posterior vaginal wall prolapse, or uterine/apical prolapse
• Coccyx fracture, subluxation or dislocation
• Levator ani muscle avulsion
• Obstetric anal sphincter injury tears, or tears to the perineum, labia, vagina, vulva, clitoris, cervix, rectum, anus or urethra
• Obstetric fistula (including vesicovaginal, colovaginal and ureterovaginal)
• Obstetric haematoma of pelvis
• Postpartum uterine inversion
• Pubic ramus fracture
• Pudendal neuropathy
• Ruptured uterus during labour
• Symphysis pubis joint capsule or ligament tear

2. Which statement regarding eligibility for coverage under the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Act 2022 is correct?
b. For those who gave birth on or after 1 October 2022, injuries registered at the time of birth or any time postpartum may be covered

3. What is a tear injury affecting the perineal muscles and fascia but not involving the anal sphincter?
b. Second-degree perineal tear

4. Which statement regarding levator ani muscle avulsions is correct?
b. Diagnosis of levator ani muscle avulsion can take up to 12 months to confirm

5. Most people with pelvic health issues due to maternal birth injuries will bring this up in postpartum consultations. True or False?
b. False

6. Symptoms of birthing injuries are also eligible for ACC coverage. True or False?
a. True

7. What symptoms or consequences of maternal birth injuries should you screen for at each postpartum check-up (and during future consultations)?
d. All of the above (anal and urinary incontinence, pelvic organ prolapse, pelvic pain and sexual dysfunction)

8. What is the best course of action for most maternal birth injuries diagnosed in primary care?
c. Referral onwards to a pelvic health physiotherapist

9. Which TWO statements regarding maternal birth injuries and their psychological effects are correct?
a. Counselling, rongoā Māori and psychological support are covered by ACC if they relate to an approved birth injury claim
d. When a physical birth injury occurs, it is highly likely that psychological distress will occur

10. Name one traditional rongoā Māori healing service also covered by ACC as a rehabilitation option.
Examples include: mirimiri (bodywork), whitiwhiti korero (support and advice), karakia (prayer), rākau rongoā (native flora herbal preparations)

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