Satisfaction with Subsequent Delivery Route Among Women Following Obstetric Anal Sphincter Injury [38M]

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We sought to assess women’s satisfaction with delivery route of their subsequent delivery following one with an obstetric anal sphincter injury (OASIS).


A survey study was conducted from July to September 2017 among women seen in a specialty postpartum perineal clinic at a tertiary teaching hospital following a vaginal delivery with an OASIS and who had a subsequent delivery from March 2012 to December 2016. Women were mailed a 13-item questionnaire addressing counseling after their OASIS and satisfaction with route of subsequent delivery. Satisfaction was assessed with a modified Decision Regret Scale. Bivariate analyses were used to compare women who were and were not satisfied with route of subsequent delivery.


Among 115 eligible women, 43 completed the survey. The majority (n=35, 81.4%) had a subsequent vaginal delivery, and 8 (18.6%) had a subsequent cesarean delivery. 34.9% (n=15) reported the counseling they received after the OASIS influenced their decision regarding route of subsequent delivery. Half (48.8%, N=21) had no regret regarding their decision on subsequent delivery route while 16 (36%) had mild, and 6 (14%) had moderate/severe regret. Regret was associated with age, (none: 36.2 ± 3.9 vs mild: 36.5 ± 3.3 vs moderate/severe: 41.1 ± 53.4 years, p = 0.02) and with difficulty holding stool (none: 9.5% vs mild: 18.8% vs moderate/severe: 83.3%, p=.002).


Most women with an obstetric anal sphincter injury laceration will choose a repeat vaginal delivery and half are satisfied with this decision. Age and difficulty holding stool were associated with regret regarding subsequent delivery mode.

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