title: Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study.
abstract: BACKGROUND
  Obstetric anal sphincter injury (OASIS) following vaginal delivery increases the risk of anal incontinence (AI). Subsequent vaginal delivery and ageing increase the risk of worsening symptoms. Very little literature describes any in-depth understanding of what it is like to live with AI following a history of known OASIS.
  
  
  OBJECTIVE
  To describe and interpret women's experience of AI following OASIS and its impact on quality of life.
  
  
  METHODS
  An interpretive phenomenological study was conducted in a level 2 tertiary hospital in South Australia. Women with a history of OASIS and AI were purposefully recruited. The St Marks Vaizey score was utilised to identify symptom severity. Semi-structured open-ended interviews were conducted, and data were analysed utilising Van Manen thematic analysis.
  
  
  RESULTS
  Participants (n = 10) aged 26-56 years. All women were symptomatic of AI following OASIS, and 80% had received a primary OASIS at their first vaginal delivery. The St Marks Vaizey score mean was 9.1 (range within 4-22). Three essential themes grieving for loss, silence, striving for normality with eight subthemes identified a significant sense of loss and psychological impact of AI for this group of women.
  
  
  CONCLUSIONS
  Health professionals require a greater understanding of the negative impact of OASIS and AI on women's quality of life. This may improve the management, education and clinical care of this condition which may result as a consequence of OASIS.
authors.affiliation: Robinson Institute School Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Tucker
authors.forename: Vicki
authors.initials: V
authors.lastname: Clifton
authors.forename: Anne
authors.initials: A
authors.lastname: Wilson
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D005242:Fecal Incontinence / Q000209:etiology / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D007407:Interviews as Topic; D022125:Lacerations / Q000150:complications*; D008019:Life Style; D008875:Middle Aged; D007744:Obstetric Labor Complications; D036801:Parturition; D010817:Physician-Patient Relations; D011247:Pregnancy; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D019529:Sexuality; D057545:Social Stigma
keywords: anal incontinence; obstetric anal sphincter injury; phenomenology; quality of life; women's experiences