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Women's experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma.

Bidwell, P; Sevdalis, N; Silverton, L; Harris, J; Gurol-Urganci, I; Hellyer, A; Freeman, R; van der Meulen, J; Thakar, R (2021) Women's experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma. Int Urogynecol J, 32 (7). pp. 1807-1816. ISSN 1433-3023 https://doi.org/10.1007/s00192-020-04653-2
SGUL Authors: Thakar, Ranee

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Abstract

INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injury (OASI) is a severe form of perineal trauma that can occur during vaginal birth. Long-term morbidities include anal incontinence and psychosocial disorders. To reduce these injuries within England, Scotland and Wales, the OASI Care Bundle was introduced to 16 maternity units (January 2017-March 2018). The OASI Care Bundle comprises four elements: (1) antenatal information, (2) manual perineal protection, (3) medio-lateral episiotomy (when indicated) and 4) recognition and diagnosis of tears. As part of the project evaluation, a qualitative study was conducted to explore women's experiences of the OASI Care Bundle. METHODS: Semi-structured interviews were conducted with women (n = 19) who received the OASI Care Bundle as part of their maternity care. This was to explore their experience of each element. A thematic analysis of the interview data was performed. RESULTS: Three themes were identified: (1) memories of touch, whereby women reported that a 'hands-on' approach to perineal protection was a positive experience; (2) midwife as a supportive guide, where women reported that good communication facilitated a calm birth and post-birth diagnosis; (3) education: women need more information about perineal trauma. CONCLUSION: This study contributes to the literature through its exploration of women's experiences of perineal protection techniques and diagnosis of perineal trauma. Interviewed women indicated that they did not experience any of the care bundle elements as an intrusion of their physical integrity. Additionally, an urgent need was identified for more information about perineal trauma in terms of risk, prevention and recovery.

Item Type: Article
Additional Information: © The Author(s) 2021 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Maternity, OASI, Perineal trauma, Qualitative, ‘Care bundle’, ‘Hands-on’, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Int Urogynecol J
ISSN: 1433-3023
Language: eng
Dates:
DateEvent
July 2021Published
21 January 2021Published Online
10 December 2020Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
7674Health Foundationhttp://dx.doi.org/10.13039/501100000724
PubMed ID: 33475817
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112996
Publisher's version: https://doi.org/10.1007/s00192-020-04653-2

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