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

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Abstract

INTRODUCTION:

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

METHODS:

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.

RESULTS:

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).

CONCLUSION:

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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