Obstetric anal sphincter injuries (OASI) are severe perineal tears that can occur during vaginal birth and involve damage to the anal sphincter muscles. These injuries are estimated to affect around 1–5% of women following childbirth and may have important implications for pelvic floor function and overall wellbeing.
Women who sustain an OASI may experience symptoms such as difficulty controlling gas or bowel motions, faecal urgency, pelvic or perineal pain, urinary symptoms, or discomfort with sexual activity. While prompt recognition and immediate surgical repair after birth are essential components of care, recovery can take time and some women may continue to notice ongoing symptoms in the months or years following delivery.
Research shows that persistent bowel or pelvic floor symptoms can impact confidence with exercise, social participation and intimacy, highlighting the importance of comprehensive follow-up and rehabilitation. Contemporary clinical guidelines recommend pelvic health physiotherapy as part of multidisciplinary recovery, supporting women to optimise pelvic floor function, improve symptom control and safely return to valued daily activities.
Future birth planning is also an important part of recovery after OASI. Women are often supported to make informed decisions about the mode of delivery in subsequent pregnancies, taking into account their current symptoms, pelvic floor function and individual preferences. Collaborative care involving obstetric providers and pelvic health physiotherapy can help guide this process, with the aim of reducing the risk of further injury while supporting confidence and wellbeing in future pregnancies.
Early assessment and individualised rehabilitation can make a meaningful difference to long-term outcomes. If you have experienced a severe tear during childbirth and are noticing ongoing pelvic floor symptoms, seeking specialised pelvic health support may help you regain comfort, confidence and function.
