Women's experiences after a third-degree obstetric anal sphincter tear: a qualitative study

Birth. 2005 Jun;32(2):129-36. doi: 10.1111/j.0730-7659.2005.00356.x.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anal Canal / injuries*
  • Female
  • Humans
  • Obstetric Labor Complications / surgery*
  • Parturition*
  • Perineum / injuries*
  • Postpartum Period*
  • Pregnancy
  • Qualitative Research
  • Risk Factors
  • Severity of Illness Index
  • United Kingdom