The GP's role in supporting women with anal incontinence after childbirth injury.

BACKGROUND: Obstetric anal sphincter injury is the most common cause of anal incontinence (AI) for women, which often has profound impacts on women's lives. GPs offer a first line of contact for many, but we know that very few women experiencing AI postnatally report discussing it with their GPs. DESIGN AND SETTING: Qualitative study investigating women's experiences with their GP and GPs' perspectives about providing such care. AIM: The study aims to identify key ways GPs can support women with AI due to childbirth injuries. METHOD: This qualitative study combined two phases: firstly, a series of in-depth interviews with women experiencing AI caused by childbirth injuries (n=41); secondly, focus groups with GPs (n=13) stratified by experience. Thematic analysis was conducted and relevant themes from across the two datasets were examined. RESULTS: Mediating factors in GP care for women with AI caused by childbirth injuries centred around three key themes: Role of the GP, Access and Pathways, and Communication. CONCLUSION: The findings demonstrate multifactorial challenges in identifying the problem and supporting women experiencing AI after childbirth injury within primary care settings. Many GPs lacked confidence in their role in supporting women and women were often reluctant to seek help. Those who did often experienced frustrations consulting with their GPs. In a context where women are often reluctant to ask for help, concerns are not always taken seriously, and where GPs do not routinely ask about AI, potential AI after childbirth injury appears to be often missed in a primary care setting.