Behavioral Therapy Of Obstetric Sphincter Tears

The primary aim of the "BOOST Cohort Study" is to determine the incidence of FI symptoms at 6 and 12 weeks postpartum in primiparous women sustaining an OASI.

Secondary aims of the cohort study are:

• To determine the incidence rates of FI symptoms at 24 weeks post delivery in primiparous women sustaining an OASI
• To examine the relationship between the modified WHO sphincter tear classification types and FI symptoms
• To examine predictors (socio-demographic, physical and clinical) associated with WHO sphincter tear classifications (3a, 3b and 4) and predictors associated with FI symptoms
• To evaluate the incidence of fecal urgency and flatal incontinence at 24 weeks postpartum in primiparous women sustaining an OASI.

Inclusion criteria

Assessed by 2 weeks postpartum

• Vaginal delivery >= 28 weeks singleton gestation
• Documented repair to the anal sphincter at delivery
• First vaginal delivery
• Ambulatory
• Able to give informed consent 6 Adult women >= 18 years of age

Inclusion criteria

at 2 weeks postpartum

• Inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease)
• Pre-pregnancy ano-rectal surgery (e.g., surgery for hemorrhoids, fissures, sphincterotomy)
• Pre-pregnancy FI (defined as the leakage of liquid/solid stool and mucus >= once per month for at least 12 weeks prior to this pregnancy)
• Neurological condition that would predispose to FI (e.g., spinal cord injury, multiple sclerosis)
• Presence of rectovaginal fistula
• Any participation in other pharmacologic or behavioral studies for FI
• Previous pregnancy >=28 weeks delivered vaginally or by Cesarean section