Consequences of obstetric anal sphincter injuries (OASIs) such as anal incontinence can lead to long-term physical and psychological sequelae. As OASIs occur more frequently in nulliparous women, women will probably present in a subsequent pregnancy. A subsequent delivery can increase the risk of developing or deteriorating anal incontinence symptoms. Therefore, counselling and mode of delivery recommendations should occur in the antenatal period to allow women to make an informed choice about their subsequent delivery. Intrapartum, obstetric practice can be adapted by clinicians, taking into account modifiable risk factors associated with repeat OASIs. However, approaches to prevention of sequelae such as anal incontinence in the long term remains unclear. Conservative options such as pelvic floor muscle training should be encouraged and in cases of intractable symptoms, surgical options are available but these should usually be considered in women who have completed their family.

The claimant, an equity sales trader in the City of London, during the birth of her first child suffered an obstetric anal sphincter injury whilst in private obstetric care. This went undetected, leaving her with significant ongoing symptoms which caused embarrassment, inconvenience and distress, resulting in an impact on her career trajectory. It was claimed that the defendant performed a midline episiotomy which caused a third-degree tear affecting both her internal and external anal sphincter.

The need for perineal repair after childbirth affects millions of women worldwide. In the United Kingdom, approximately 85% of women sustain some form of perineal trauma during vaginal delivery, and 69% of these will require stitches.