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Counseling After Obstetric Anal Sphincter Injury: How do Health Care Providers Perform?
Madeline Freeman1, Emily Lluch2, Jason Benedict3
1Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH.
Urogynecology (Philadelphia, Pa.)
|May 12, 2026
Summary
Only 39% of patients with prior obstetric anal sphincter injuries received counseling in subsequent pregnancies. This counseling influenced delivery decisions, increasing cesarean rates for those informed about their injury history.
Area of Science:
- Obstetrics and Gynecology
- Maternal Fetal Medicine
- Pelvic Floor Disorders
Background:
- Obstetric anal sphincter injuries (OASIS) cause significant morbidity and increase recurrence risk.
- Proper counseling and delivery planning are crucial for subsequent pregnancies after OASIS.
Purpose of the Study:
- Determine the counseling rate for OASIS patients in subsequent pregnancies.
- Assess counseling quality, impact on delivery choices, and risk factor correlations.
Main Methods:
- Descriptive cohort study utilizing electronic medical records.
- International Classification of Diseases codes and delivery summaries identified participants.
- Two academic institutions contributed data.
Main Results:
- 39% of 218 eligible patients received OASIS counseling in their first subsequent pregnancy.
- Patients with severe OASIS or sequelae (incontinence, trauma) were more likely to be counseled.
- Counseling was associated with a higher cesarean delivery rate (25% vs 5%), with 62% of these for OASIS history.
Conclusions:
- The rate of OASIS counseling in subsequent pregnancies is low.
- Further research is needed to explore reasons for low counseling rates and its impact on delivery planning.
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