Skip to main content

Tackling maternal and ethnicity health inequalities while breaking the silence around obstetric anal sphincter injury (OASI)

Maternal health was the focus of one of Irwin Mitchell’s webinars examining the impact of ethnicity on health inequalities.

The session was led by senior associate Geeta Nayar, who is a leading campaigner for women who have suffered serious injuries during childbirth. Geeta, an advocate and council member for The MASIC Foundation, the only multi-disciplinary UK charity to support women who have suffered obstetric anal sphincter injuries (also known as 3rd and 4th degree tears), was joined by the Immediate Past President of the Royal College of Obstetricians and Gynaecologists (RCOG) Dr Edward Morris. 

Now the NHS England Regional Medical Director for the East of England, Dr Morris took up his presidency of the RCOG in 2019 and during his time he covered the COVID-19 pandemic, rapidly producing the RCOG COVID guidance, the call for workforce investment and the need to address health inequalities.

The webinar explored the Royal College of Obstetricians and Gynaecologists (RCOG’s) commitment to working with a taskforce to understand why these disparities in maternal healthcare exist and identifying meaningful solutions to improve them.

The important subject of severe perineal injuries, in particular obstetric anal sphincter injuries was also discussed. These types of injuries can occur during vaginal birth and can cause bowel incontinence and other pelvic floor dysfunction such as urinary incontinence, debilitating pelvic pain and pelvic organ prolapse. Few people are aware that these types of maternal injury disproportionately affect women from ethnic minority backgrounds.

Geeta talked about her own lived experience, sustaining a life-changing OASI injury during the birth of her first child at a time when she was practising as a serious injury and medical negligence solicitor at Irwin Mitchell. Her journey led her to the work of The MASIC Foundation where she became an advocate and council member promoting the need for greater awareness in recent years.

A study conducted by The MASIC Foundation found that 85% of women who had suffered a perineal injury said it had impacted on the relationship with their child and 50% of women stated they were unable to do day-to-day activities due to their injuries.

The average incidence of OASI in the UK is 6.1% in first births, meaning around 1 in 20 first-time mums suffer this type of serious injury. The MASIC Foundation is committed to the better detection and prevention of injury during childbirth, and for a comprehensive assessment for OASI injuries following all births, which will also help identify women who are less likely to report injuries due to cultural reasons.

Geeta said: “The failure to recognise language barriers, cultural stigma and structural difficulties in maternal healthcare are overwhelming discriminatory factors which can lead to a lack of informed consent - a basic and fundamental right of every woman in childbirth.”

She has now returned to Irwin Mitchell and is specialising in working with maternal injury clients, charities and organisations to improve outcomes for all women affected by these devastating injuries.

These injuries, whilst life-changing and often permanent, are still not widely talked about due to societal stigma. The risk of maternal injuries needs to be discussed more openly throughout pregnancy so that women are better informed to make choices, and there needs to be a clear pathway of care within the NHS to support the complex needs of severe perineal injury.

Find out more about Irwin Mitchell’s expertise in supporting women who are affected by maternal injuries at our dedicated section on the website.

View the webinar