O&G professionals’ understanding of levator and OASI Injuries, their views on antenatal counselling and obtaining informed consent for obstetric interventions: An online survey

Introduction/Hypothesis: Obstetric anal sphincter injuries (OASI) and levator ani trauma are common maternal injuries. Our aim was to explore the understanding of these injuries by O&G professionals in addition to their views on antenatal counselling and obtaining informed consent for potential maternal birth injuries. Methods: An online survey was conducted among O&G professionals across 4 metropolitan Sydney Hospitals. It encompasses twenty-four items in four main domains consisting of a series of multiple-choice questions. These four domains are (1) Respondent characteristics; (2) Understanding/teaching of OASI and levator trauma; (3) Views on antenatal counselling; (4) Views on obtaining written informed consent for obstetric interventions. Results: 165 individuals responded (32 %), 65 % were midwives and 30 % were doctors. 99 % of them had prior knowledge of OASI, but this figure was only 62 % for levator trauma. More doctors have heard about levator trauma (94 % vs 50 % for midwives; P < 0.001) and more doctors considered themselves to be very well/well informed of the condition (57 % vs 20 % for midwives, P = 0.002). Adequacy of teaching was considered fair/poor for levator trauma by 78 % of respondents compared to 35 % for OASI. Only 26 % learned about levator trauma mainly from standard teaching. 81 % supported discussion of maternal trauma and 76 % supported obtaining written informed consent for obstetric interventions. Conclusion: Levator trauma is much less well recognized than OASI. A lack of standard teaching may be contributory and may constitute one of the challenges in patient counselling and obtaining informed consent for obstetric interventions, supported by the majority of respondents.