Opera singer, 33, 'suffered botched episiotomy that led to excessive flatulence and left her unable to perform'

Amy Herbst gave birth to her first child, a boy, in February 2012

Nurse performed an episiotomy - where tissue is cut between the vagina and anus - 'without her consent and did not properly close the wound'

The procedure 'has left Mrs Herbst with severe damage to her genitals and flatulence and incontinence, which have left her unable to perform'

Mrs Herbst and her husband are suing the government for $2.5 million



An opera singer has claimed a military nurse carried out an unnecessary episiotomy on her during childbirth - leaving her with incontinence and flatulence so bad that she is unable to perform.



Amy Herbst, 33, alleges in a lawsuit filed against the government on Monday that nurse-midwife Tiffany Williams carried out the procedure without her consent and subsequently damaged her digestive and reproductive systems - as well as her singing career.



The lawsuit filed by Herbst and her husband, Staff Sgt. James Herbst, in Cincinnati federal court seeks $2.5 million for negligence, as well as pain and suffering, embarrassment and loss of income.

'She is suffering through a very embarrassing and very significant injury, and frankly, the prognosis of a fully successful repair is pretty low,' her attorney, Charles Allen, told Army Times on Wednesday.

Injuries: Amy Herbst was given an episiotomy without her consent while giving birth to her son in 2012. It left her with severe damage and incontinence that has threatened her opera career, she said

The damage also means that she now suffers pain during sex, according to the lawsuit. As a result, her husband is also suing the government for lack of consortium.

An episiotomy, which involves cutting the tissue between the vagina and anus, is carried out to help deliver the baby and when the skin is at danger of tearing.

But Mrs Herbst claims that Williams carried out the procedure at Blanchfield Army Community Hospital at Fort Campbell, Kentucky, in February 2012 without her consent.

'At no time during the labor and delivery process was [she] informed about the possible need for or the risks and benefits of an episiotomy,' the lawsuit says. 'At no time was she asked to consent, nor did she consent, to the performance of an episiotomy.'



Nevertheless, birth records show that the procedure was carried out as the placement of the baby boy's shoulder was holding back the delivery.

The nurse then repaired the tear using sutures.

Family: Mrs Herbst and her husband James, who welcomed their first son in February 2012, have now sued the U.S. government for the allegedly botched procedure carried out by a military nurse

WHEN TO HAVE AN EPISIOTOMY: THE PROS AND CONS OF PROCEDURE

An episiotomy is a surgical incision in the perineum, the area between the vagina and the anus, made just before childbirth to enlarge a woman's vaginal opening.

The procedure used to be routine to prevent the vagina from tearing, in the belief that this cut would help women heal easier than a spontaneous tear.

CONS

Research shows women with a spontaneous tear actually recover in the same or less time than women who have had an episiotomy.

Women who have had an episiotomy also tend to lose more blood during the delivery and experience more pain during their recovery.

The tear also has a greater chance of becoming larger and research shows it increases the risk of tearing in a second birth. It also increases the risk of infection.

The American Congress of Obstetricians and Gynecologists and other experts now agree that the procedure shouldn't be done routinely.

PROS

But if a baby is very large or in an abnormal position and a doctor needs space for forceps, an episiotomy can be carried out.

It can also help when the baby needs to be delivered as quickly as possible - if it is experiencing difficulties such as a drop in heart rate.

Mothers-to-be are encouraged to speak with their practitioner to find out in what conditions he or she would perform an episiotomy. Midwives carry out the procedure much less than obstetricians.

Although Allen said that the placement of the boy's shoulder probably led to the decision, he argued that they could have used other, safer ways to deliver the boy - but they did not.

'There seemed to be an assumption that they didn’t need to involve the patient in the decision making... and they were completely wrong, as a matter of law and social responsibility,' Allen said. 'The patient has a right to decide what’s done with her body.'

After Herbst left the hospital, she 'began to experience fecal urgency and incontinence, including periodic leaking of stool and excessive flatulence,' according to the lawsuit.

At a follow-up hospital visit, she met with a nurse and 'complained she could feel gas coming out of her vagina and was also experiencing difficulty controlling bowel movements', the suit says.



A nurse told Herbst that the attempts to repair her incision had not worked.



Mrs Herbst had suffered a 'complete breakdown of the episiotomy and perineum and the external sphincter is disrupted and the vagina and rectum are basically connected without any perineal body,' the lawsuit claims.

A colorectal surgeon at Vanderbilt University Medical Center later told Herbst that she would need reconstructive surgery to repair the damage, but that it 'would likely not eliminate the lack of control of flatus and [she] may require additional surgeries in the future'.



She was also told that once the repair was performed, she will have to undergo a C-section in any future pregnancies.



When she told medical staff that C-sections could risk her singing career, they encouraged her not to undergo the procedure until she had finished having children, the suit says.

Mrs Herbst agreed and has chosen to postpone the repair of the damage.



A hospital spokesperson has not returned calls seeking comment.

The lawsuit claims that Herbst, a mezzo-soprano, is now unable to work as a professional opera singer. She has performed with the Nashville Opera Company.

'As a result of her incontinence and excessive flatulence, Herbst has been unable to work as a professional opera singer,' it says.

Scene: She gave birth to her son at Blanchfield Army Community Hospital. On follow-up visits, she learned that reconstructive surgery will not necessarily repair the damage, her lawsuit says

It has also left her with limitations on her sexual function, as well as pain during sex, the suit states.



Online records also show that Herbst has worked as a music instructor at Belmont University, where she received her master's in music and vocal performance.



Her husband was a soldier at Fort Campbell on the Kentucky-Tennessee state line at the time but has since left the Army.