Women’s experiences following obstetric anal sphincter injury

Author(s): I. d’Almeida - Pages: 39-50

Abstract

The aims of this literature review were to examine: the quantitative and qualitative literature on the physical and emotional experience of women who sustain obstetric anal sphincter injuries (OASIs); and the impact that this condition has on their well-being in the postnatal period and beyond. There is a large body of research into the management of patients with OASIs, including evidence relating to risk factors and medical/surgical management. There are also known long-term implications for women who sustain OASIs, and existing recommendations for treatment.

The focus of current research is either on how perineal trauma can be avoided, or the best method of surgical repair. It rarely takes into account the viewpoint and experiences of the women who sustain such injuries, or the impact that these have on their emotional and psychological well-being.

The electronic databases searched up until April 2019 included MEDLINE, Embase, AMED, CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews. The search identified five papers that specifically examined women’s experiences after they had sustained OASIs. These were all qualitative studies that used either structured or semi-structured interviews or questionnaires. No quantitative papers were identified. All five papers identified similar themes, including a negative physical and psychological impact, unmet expectations, and problems within the healthcare system. More research is needed to explore this area because an understanding of women’s experiences of OASIs is essential in order to improve antenatal and postnatal care.

Keywords: birth injury, obstetric anal sphincter injuries, postnatal care, vaginal birth, women’s experience.