Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study

Abstract

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.

A systematic mixed studies review of women's experiences of perineal trauma sustained during childbirth

“…For women suffering from incontinence, they described how unexpected episodes negatively impacted on previously taken‐for‐granted activities and placed restrictions on their social life (Herron‐Marx, Williams, & Hicks, ; O'Reilly et al., ). They described the daily struggle to manage their symptoms and the isolation and loneliness they experienced when keeping incontinence hidden from others, particularly anal incontinence (Tucker, Clifton, & Wilson, ). Women described how they felt it was not culturally appropriate to talk about their difficulties with friends or family due to the social stigma of being incontinent and being perceived as dirty and/or lazy (Gillard & Shamley, ; Herron‐Marx et al., ; Priddis, Schmied, & Dahlen, ; Priddis, Schmied, Kettle, et al., ; Tucker et al., ).…”

“…Those with enduring symptoms described their guilt when they would have to put their needs before that of others and felt this contradicted their role as a good mother/partner (Tucker et al., ). Although some women felt that sexual contact was a necessary part of their romantic relationship, others felt it was simply a “fulfilment of their duty” with an emphasis on being “back to normal” by 6 weeks after the birth (Priddis, Schmied, & Dahlen, ; Priddis, Schmied, Kettle, et al., ).…”

“…Sexual problems were frequently cited by women who experienced perineal trauma, especially those who experienced OASI (Priddis, Schmied, & Dahlen, ; Priddis, Schmied, Kettle, et al., ). Women described the fear of pain or episodes of incontinence as a reason for abstinence or delay of sexual intimacy (O'Reilly et al., ; Priddis, Schmied, & Dahlen, ; Priddis, Schmied, Kettle, et al., ; Tucker et al., ; Williams et al., ). Those with OASI described a fear of becoming pregnant and experiencing OASI again as a reason for abstinence (Priddis, Schmied, & Dahlen, ; Priddis, Schmied, Kettle, et al., ; Williams et al., ).…”

“…When addressing their concerns with their healthcare providers, women described how their expectations were unfulfilled and their questions unanswered, leaving them feeling frustrated and projecting their healthcare provider in an unfavourable and unknowledgeable light (Priddis, Schmied, & Dahlen, ; Williams et al., ). The majority of women described a “professional silence” from healthcare professionals which resulted in women feeling that their symptoms are not culturally acceptable to be discussed or were a normal consequence of childbirth (Herron‐Marx et al., ; Tucker et al., ).…”

The long-term physical, emotional and psychosexual outcomes related to anal incontinence after severe perineal trauma at childbirth

“…Most studies in the literature have focused on the general impact of AI on the quality of life, with only few studies focusing on the specific emotional and psychological consequences of AI following OASIS at childbirth. Women suffering with AI who sustained OASIS at birth have higher rates of negative body image, sexual dysfunction and increased levels of anxiety and depression [20][21][22] . It has been described that these women feel embarrassed and ashamed 21 .…”