Women’s choices and preferences for subsequent mode of birth following an obstetric anal sphincter injury (OASI): A scoping review

<p dir="ltr">Background: Obstetric anal sphincter injury (OASI) may result in physical and psychological maternal health consequences. Women's choice or preference for mode of birth following OASI has not been extensively researched. Objectives: The scoping review aimed to identify, appraise and synthesise published literature. Eligibility criteria: All study designs, primary peer-reviewed research publications, publications with explicit mention of maternal choice or preference for mode of birth in a subsequent birth following a previous OASI. Sources of evidence: A systematic search of CINAHL, Medline and Web of Science databases was conducted. Charting methods: Primary research, English language publications with explicit mention of maternal choice or preference for mode of birth following OASI were included. No date limits were set. Quality appraisal was performed, and results synthesised. Results: Of 1031 records screened, 63 full-text publications were assessed against inclusion criteria, resulting in 10 publications identified. Two additional publications were identified through reference list checks of included studies. Of 12 included publications, 11 used quantitative and one qualitative approach. Common themes such as mode of birth, faecal or urinary incontinence, guidance/counselling, risk of recurrence, OASI classification and sexual function were identified. Conclusions: Preference or choice of mode of birth is multifactorial. There is minimal evidence containing participant voices identified in the published literature on this topic. More qualitative research is needed to ascertain what preferences women have and why they make the choices that they do in relation to mode of birth in subsequent pregnancy. Structured Statement of significance: Obstetric anal sphincter injury can be a serious, life altering and devastating injury occurring during childbirth. Despite the impact of OASI, limited research has been undertaken regarding women's preferences and decisions surrounding subsequent mode of birth following OASI. Existing published literature has been predominantly quantitative in nature, with a notable lack of qualitative research found. This paper summarises the current body of research literature on this important women's health topic, and identifies the need for further qualitative research on this topic, allowing the voices of women to be heard regarding their lived experiences.</p>