Abstract
Purpose
Maternal request for caesarean section (CS) is increasing. One common reason is following
a previous obstetric anal sphincter injury (OASI). We aim to understand which factors
bear the greatest influence in driving this women’s decision-making process once they
are pregnant after having sustained an OASI.
Methods
Pregnant women with a previous OASIS who were attending their first antenatal appointment
were deemed eligible and were asked to complete two questionnaires on their preferred
mode of delivery (MoD) and ongoing pelvic floor symptomatology. Data were analysed
with descriptive and inferential statistics using SPSS, and results were presented
both quanti- and qualitatively.
Results
Data from 63 participants was included in the final analysis. Most women had experienced
3A/3B OASIS (n = 49, 77.78 %), and they were more likely to report bladder pain and
difficulties with voiding than those with major tears (p < 0.05). The type of tear
did not impact directly on the preferred MoD. However, women still experiencing bladder
pain were more likely to request a CS (p < 0.05). Even though all participants who
attended a perineal trauma clinic postpartum found it helpful, they reported that
ultimately the decision on how to deliver was theirs, and their ideas and concerns
played the greatest influence.
Conclusion
Pregnant women with ongoing urinary symptoms rather than sexual or bowel dysfunction
seem to favour a planned CS, regardless of the severity of their previous tear. Postpartum
follow-up in a perineal trauma clinic is extremely valuable but even more is the need
to understand women’s motivations to support them make an informed decision.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 26,
2022
Received in revised form:
October 9,
2022
Received:
August 29,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
