Background Childbirth is a common factor which increases the risk of obstetric anal sphincter injuries (OASIS). Damage to the anal sphincters increases the risk of anal incontinence, which has a debilitating impact on the quality of life. Post‐repair laxatives are prescribed in this group of women. However, there is no consensus regarding the type or frequency with which they are used, and available guidelines lack consistency and evidence to support the recommendations. Aim The aim was to review and compare the international, national and local Australian management guidelines for recommendations regarding laxative use in women after OASIS. Method An online literature search of medical and nursing databases such as PubMed, Embase, MEDLINE, CINAHL, Web of Science, Scopus and Cochrane was performed between January 2000 and October 2020. Full‐text articles with MeSH headings and Text Words [TW] identified guidelines in the prevention, management and care of OASIS. The search terms included ‘obstetric anal sphincter injury’, ‘OASIS’, ‘perineal tear’, ‘postpartum continence’, ‘bowel injury’, ‘aperient’, ‘laxative use’ and ‘bulking agents’. Results Thirteen guidelines were included. Laxatives were recommended in most guidelines; however, there was a lack of consistency regarding the type of laxative used, frequency, dose and duration of use. Guidelines were based on historical evidence, with paucity of recently acquired data identified. Conclusions There is no consensus regarding an optimal laxative regime for women who sustain an anal sphincter injury after childbirth. Further research is required to develop evidence‐based robust clinical guidelines regarding laxative use in women who sustain OASIS.

BACKGROUND: Neuromuscular and mechanical damage to the pelvic floor because of pregnancy and birth can result in anal incontinence. Pregnant and postnatal women are rarely screened for anal incontinence by clinicians who specialize in the care of these women, and no screening tool has been developed for routine use in these women. OBJECTIVE: To develop and validate a tool for use in everyday clinical practice in the care of pregnant and postnatal women. DATA SOURCES: The study includes 2 test phases with separate data sources. Phase 1, test, and re-test phase of the Bowel Screening Questionnaire in health professionals and women who were pregnant or had recently birthed (n = 45). Phase 2 included a pilot of the tool as compared to two current scoring systems (n = 358). SETTING: Large tertiary hospital in South Australia. PATIENTS: Phase 2: prospective recruitment of 358 prenatal parous women attending a first antenatal appointment. MAIN OUTCOMES MEASURES: To evaluate the reliability and validity of the developed tool. RESULTS: Test-retest agreement in phase 1 was excellent for each of the 6 items with each kappa statistic being between 0.83 and 1.0. In phase 2 agreement between new and existing tools was fair to good for the detection of anal incontinence symptoms addressed as a composite question (kappa between 0.41- 0.71). Anal incontinence was detected in 191 (53%) of women utilizing the new tool, and there was a lower prevalence reported using the Vaizey score (n = 118) and Wexner score (n = 129). Completion rates of the new tool were 99%, higher than both the Vaizey score (33%) and Wexner scores (36%). LIMITATIONS: Sample size limits generalization of findings. CONCLUSION: The questionnaire is reliable and valid reporting a high incidence of bowel incontinence, with predominant symptoms of rectal urgency and flatus as precursors for worsening function.