Background: Obstetric anal sphincter injury (OASIS) is a significant complication of vaginal delivery that may lead to long-term morbidity, including anal incontinence and reduced quality of life. Reported incidence ranges from 0.5–3% in Europe. Clinical guidelines recommend prompt recognition, repair by trained clinicians, and appropriate postpartum follow-up. This audit aimed to determine the incidence of OASIS in Midland Regional Hospital Portlaoise and assess adherence to national management guidelines.

Methods: A retrospective audit of all deliveries between 1 July and 30 September 2025 was conducted. Data were obtained from delivery registers, electronic patient records, theatre logs, and physiotherapy notes. Variables included maternal demographics, mode of delivery, grade of perineal tear, repair details, and postoperative management. Audit standards were based on national clinical practice guidelines and recommendations from the Royal College of Obstetricians and Gynaecologists.

Results: During the study period, 363 deliveries were recorded. Perineal trauma included 33 first-degree tears, 51 second-degree tears, and 2 third-degree tears (one 3A and one 3B). No fourth-degree tears were identified. The overall OASIS incidence was 0.55% (2/363). Both injuries occurred following vaginal delivery and were repaired in theatre under general anaesthesia by a consultant obstetrician. Documentation of repair technique and suture material was complete. Postpartum laxatives and physiotherapy review were provided in both cases, achieving 100% compliance with audited standards.

Conclusion: OASIS incidence at our unit was low, with full adherence to recommended management standards. Ongoing training, standardized documentation, and planned re-audit are recommended to maintain high-quality care.

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