S9 | E94 Obstetric Anal Sphincter Injuries from Birth and Their Life-Altering Impact On Two Women
Trigger Warning: Birth trauma, Mental Health Struggles, Suicide, and Sexual Assault
SOLACE (Severe Obstetric Laceration Awareness and Community Engagement) is a non-profit that was founded by Caroline Stadler in April of 2023. Caroline sustained a missed a 4th degree tear from a forceps delivery when giving birth to her daughter in 2022. She struggled both physically and mentally as she navigated care for her symptoms and recovery due to a lack of structured resources available in the United States. Caroline was then joined on the board of SOLACE by multiple women who had similar journeys and medical professionals who were passionate about making a change in the awareness and after care of severe tearing.
Caroline and Sepideh Share:
While obstetric data reports a 6-7 percent rate of Obstetric Anal Sphincter Injuries (OASI), looking at the ultrasound data shows that up to 40% of patients who have had a prior vaginal delivery have sphincter defects that were never diagnosed: https://www.nejm.org/doi/full/10.1056/NEJM199312233292601 (Also: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.18827). In addition to OASIS, 20 to 35% of moms who have had a vaginal delivery will suffer from a LAM (Levator Ani Muscles) injury which predisposes them to prolapses and incontinence. While there are surgical and non-surgical options for both anal sphincter and LAM injuries, the success rates are low and women often suffer from symptoms for a life-time.
Vacuum and Forceps deliveries, especially forceps are major risk factors for an OASI.
Based on a recent survey by the MASIC Foundation in the UK, 45% of women with OASIS experience postpartum depression and 78% have traumatic memories of their birth experience.
An OASI (Obstetric Anal Sphincter Injury) has negative impacts on many dimensions of a woman's life. 50% of women in medium-term studies experience anal incontinence and 54% state that their symptoms are unacceptable and cause them to alter their lifestyle: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093361/
Obstetric training for the diagnosis and repair of anal sphincter injuries is inadequate in the US: https://consultqd.clevelandclinic.org/obstetric-anal-sphincter-injuries
Show Notes:
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