Women's experiences after a third-degree obstetric anal sphincter tear: a qualitative study.
BACKGROUND
Little qualitative data are available that address the experiences of women who sustain a third-degree obstetric anal sphincter tear during childbirth. The objective of this study was to explore the views and experiences of women in the postpartum period after sustaining a third-degree obstetric anal sphincter tear.


METHODS
A qualitative study was conducted using focus groups in a large maternity hospital in the United Kingdom. Two focus groups used a purposive sample of women who had suffered a third-degree tear. One group (n = 6) had a tear in the index pregnancy and the second group (n = 4) had a subsequent pregnancy after the tear.


RESULTS
The main themes identified included apprehension about consequences of the injury in terms of continence; body image and sexual functioning; anxiety about and lack of involvement in planning for future pregnancies; poor information exchange and communication (including both content and timing of discussions); poor emotional support from professionals and family members; physical and emotional impact; and unresolved anxieties in partners. Similarities occurred across both groups.


CONCLUSIONS
A third-degree tear causes a significant emotional and psychological impact on women's physical and emotional well-being. We recommend that all staff receive adequate training to deal with the issues that may be raised. The provision of a dedicated, multidisciplinary team involved at an early stage to coordinate the repair and follow-up is recommended to allow a sensitive, consistent, evidence-based approach, particularly in terms of decision-making for subsequent births. The experiences and needs of partners require further study.
Williams
Abimbola
A
Urodynamics Department, Liverpool Women's Hospital, Liverpool, United Kingdom.
Lavender
Tina
T
Richmond
David H
DH
Tincello
Douglas G
DG
D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000601:surgery*; D036801:Parturition; D010502:Perineum / Q000293:injuries*; D049590:Postpartum Period; D011247:Pregnancy; D036301:Qualitative Research; D012307:Risk Factors; D012720:Severity of Illness Index; D006113:United Kingdom