Resources: Anal (bowel) incontinence in childbirth

Bowel (anal) incontinence in childbirth affects over one in ten mothers after giving birth. It usually manifests as urgency, not reaching the toilet in time, embarrassing lack of control of gas and leakages.

Many cases are due to sphincter injuries termed OASI (obstetric anal sphincter injury) occurring in 6% of all births, pelvic floor damage and neuropathy. MASIC mothers feel unclean, become isolated in society, fear an accident during sex and are unable to talk about this ‘unspoken taboo’.

This resource provides information for mothers on specific therapies, coping strategies and improving quality of life. It also consists of injured mothers telling their story and commenting on areas that need to be improved.

For the medical profession, there are lectures and resources on identification and prevention of injuries to allow for optimal repairs at birth. There is also information on improving public awareness which is particularly beneficial for midwives and general practitioners. 

11 items

lectures

15:11

Professor Khaled Ismail, Obstetrician and Gynaecologist.

Date: 22nd March 2017
Free View
10:20

Professor Doreen McClurg, Physiotherapist.

Date: 22nd March 2017
Free View
07:18

Professor Michael Keighley, Colorectal Surgeon, and President of The MASIC Foundation.

Date: 6th April 2017
Free View
11:58

Ms Julia Herbert, Continence Physiotherapist.

Date: 22nd March 2017
Free View
11:54

Ms Yvette Perston, Functional Bowel Clinical Nurse Specialist, Queen Elizabeth Hospital Birmingham.

Date: 6th April 2017
Free View
16:41

Ms Camilla Palmer QC (Hon), Employment Lawyer and Judge, Joint CEO, Your Employment Settlement Service.

Date: 22nd March 2017
Free View
09:28

Professor Helen Stokes-Lampard, Chairman, Royal College of General Practitioners.

Date: 22nd March 2017
Free View
09:49

Professor Lesley Page CBE, President, Royal College of Midwives.

Date: 22nd March 2017
Free View
08:46

Ms Vivienne Novis, Midwife Lead, Royal College of Obstetricians and Gynaecologists, Royal College of Midwifey and Obstetric Anal Sphincter Injury Care bundle, Royal College of Obstetricians and Gynaecologist.

Date: 22nd March 2017
Free View
13:28

Professor Robert Freeman, Consultant Urogynaecologist, Plymouth Hospitals NHS Trust.

Date: 22nd March 2017
Free View
18:03

Ms Julie Frohlich, Midwife.

Date: 22nd March 2017
Free View
3 items

interviews and other videos

13:34

Ms Julie Frohlich, Midwife, Guy's and St Thomas' NHS Foundation Trust. 

Ms Yvette Perston, Functional Bowel Clinical Nurse Specialist, Queen Elizabeth Hospital Birmingham.

Date: 22nd March 2017
Free View
13:25

Ms Karen Evans, Physiotherapist, Burchfield Physiotherapy.

Anonymous Speaker. Speech has been distorted to protect the speaker.

Date: 28th March 2017
Free View
09:01

Ms Sara Webb, Specialist Perineal Midwife, Birmingham Women's and Children's NHS Foundation Trust.

Professor Helen Stokes-Lampard, Chairman, Royal College of General Practitioners.

Date: 28th March 2017
Free View

key references

All the references listed below are available in the RSM Library collection and can be accessed via the RSM’s e-resources area. 

Brown, S., Gartland, D., Perlen, S., McDonald, E., and MacArthur, C. (2015). Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study. BJOG: an international journal of obstetrics and gynaecology, 122(7), pp. 954-62.

Duelund-Jakobsen, J., Haas, S., Buntzen, S., Lundby, L., Bøje, G., and Laurberg, S. (2015). Nurse-led clinics can manage faecal incontinence effectively: results from a tertiary referral centre. Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland, 17(8), pp. 710-5.

Frudinger, A., Pfeifer, J., Paede, J., Kolovetsiou-Kreiner, V., Marksteiner, R., and Halligan, S. (2015). Autologous skeletal-muscle-derived cell injection for anal incontinence due to obstetric trauma: a 5-year follow-up of an initial study of 10 patients. Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland, 17(9), pp. 794-801.

Glazener, C. M. A., MacArthur, C., Hagen, S., Elders, A., Lancashire, R., Herbison, G. P., and Wilson, P. D. (2014). Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes: randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology, 121(1), pp. 112-20.

Hainsworth, A. J., Schizas, A. M. P., Brown, S., and Williams, A. B. (2016). The future of pelvic floor services in the UK. Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland, 18(11), pp. 1087-1093.

Jones, H. J. S., Gosselink, M. P., Fourie, S., and Lindsey, I. (2015). Is group pelvic floor retraining as effective as individual treatment? Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland, 17(6), pp. 515-21.

Malouf, A. J., Norton, C. S., Engel, A. F., Nicholls, R. J., and Kamm, M. A. (2000). Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. The Lancet, 355(9200), pp. 260-265.

Thin, N. N. et al. (2015) Randomised clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence. British Journal of Surgery, 102(4), pp. 349-358.

Tucker, J., Clifton, V., and Wilson, A. (2014). Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 54(4), pp. 377-81.

 

external references

The following references are not available in the RSM Library; however, they can be accessed online via external websites.

Keighley, M. R. B., Perston, Y., Bradshaw, E., Hayes, J., Keighley, D. M., and Webb, S. (2016). The social, psychological, emotional morbidity and adjustment techniques for women with anal incontinence following Obstetric Anal Sphincter Injury: use of a word picture to identify a hidden syndrome. BMC pregnancy and childbirth, 16(1), pp. 275. Available from BioMed Central: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-1065-y