Exploring the understanding of OASI risk in post-partum women

  • Research type

    Research Study

  • Full title

    Exploring the understanding of OASI risk in post-partum women who have sustained an OASI.

  • IRAS ID

    311673

  • Contact name

    Elizabeth Doxford-Hook

  • Contact email

    elizabeth.doxford-hook@nhs.net

  • Sponsor organisation

    Leeds Teaching Hospital Trust

  • Duration of Study in the UK

    0 years, 6 months, 2 days

  • Research summary

    Women who have vaginal deliveries are at risk of perineal trauma, the rate of this in the UK in first-time mothers is 85% (1,2). Perineal trauma is a spectrum of injury, classified using a numerical scale 1st to 4th. First degree tears involve grazes of the vaginal mucosa and 2nd degree tears involve the vaginal muscle. Third degree tears involve damage to the anal sphincter complex and are given a sub-grade a-c depending on the thickness of injury. If the anal sphincter is completely torn along with the anal mucosa, it consequently being classified as a 4th degree tear. Obstetric anal sphincter injury (OASI) causes great morbidity to young women including anal incontinence, dyspareunia, pain and fistula (3).

    Most of the research of OASI is focussed on prevention or repair. Fewer studies have been performed focussing on the experiences of women who have sustained OASI. Poor antenatal information about the risk of OASI and recovery is a recurring theme in qualitative studies (4,5). During the OASI Care Bundle analysis, all women were given leaflets about OASI but few remember receiving or reading them (4). Medico-legal changes in obstetrics especially are encouraging obstetricians to provide informed decisions about their care, driven by the Montgomery vs Lanarkshire case (6). Consequently, it is important to ensure women have an accessible form of information about their risks of childbirth. Another facet to be explored is the satisfaction with birth, and in the context of sustaining an OASI, would they choose a vaginal birth again. Or if they had the information about OASI would they consider a different mode of delivery.

    This study aims to explore the antenatal experiences of women who sustained an OASI in labour. It will also focus on the woman’s antenatal information delivery and their decision making regarding mode of delivery in the context of OASI.

  • REC name

    North West - Greater Manchester East Research Ethics Committee

  • REC reference

    22/NW/0078

  • Date of REC Opinion

    20 May 2022

  • REC opinion

    Further Information Favourable Opinion