1. The OASIS Syndrome Professor MRB Keighley
Discoveries from an MA Durham
Case studies and interviews ( )
Interviews – Health Professionals (12)
Focus Group ( )
MASIC IS BORN

2. Anal incontinence (AI: lack of control of wind and waste) occurs in over 1:10 mothers after having a baby through the birth canal
Obstetric anal sphincter injuries (oasis) is the term to describe these mothers. The risk factors for AI in OASIS are:-
1st vaginal delivery
Instrumental delivery; forceps > ventouse
Big baby small pelvis
Post maturity
Long second stage pushing
Poor control of perineum at childbirth

3. Results: 81 Case Studies of AI in OASIS
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Results: 81 Case Studies of AI in OASIS
Risk:
68 First Baby (84%)
70 Assisted Births (70%)
11 ventouse alone
23 forceps alone
23 ventouse → forceps
79 Anatomical Injury
2 neuropathy alone (23 neuropathy and OASI)
41 Incorrect Assessment of Injury (54%)
25 missed third degree
16 missed fourth degree
24 Sustained a Fistula
10 Anoperineal
14 rectovaginal
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 3

4. Hiding My Condition ‘I keep hiding the dirty linen’
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Hiding My Condition
‘I keep hiding the dirty linen’
‘I did not want my children to know’
‘I hope to keep it a secret’
‘It is best not to talk about it’
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 4

5. ‘I feel constantly unclean’ ‘I'm obsessed with washing’
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Unclean
‘I feel constantly unclean’
‘I'm obsessed with washing’
‘I feel dirty’
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 5

6. 4/6/ :22 PM
Sexual Horrors
‘We have had no sexual encounters since the birth (over 3 years)’
‘It is never spontaneous’
‘I am always worried I may leak’
‘I have to shower beforehand’
‘I go to bed early in order to avoid it’
‘He is hardly a husband anymore…more like a carer’
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 6

7. Isolation Embarrassed ‘I am afraid to go out of the house’
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Isolation
‘I am afraid to go out of the house’
‘I cannot talk to people and I feel isolated’
‘I dare not socialise’
‘I have no control over wind which is a great embarrassment’
Embarrassed
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 7

8. Motherhood Loss of Confidence Employment No one to talk to
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Motherhood
Loss of Confidence
‘I need a lot of support and reassurance’
‘I feel bad I cannot join in school activities’
‘I feel a failure as a mother’
‘I have lost my job’
‘I feel unable to talk to anyone’
‘I cannot hide my condition at work’
Employment
No one to talk to
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 8

9. Coping; Washing Planning the day Sharing
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Coping;
Washing
I feel better once I have washed
I shower many times a day
We have a tap with a hose as in most Asian homes
Planning the day
I must plan my day carefully
Radar key availability is a life saver
If I starve I cope better
Sharing
Silence is not helpful
I have found a soul mate
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 9

10. Recovery and Healing; Hope My Baby Not alone Love Blessings
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Recovery and Healing;
Hope
I have not given up hope
I believe in something beyond myself which I find helpful
My Baby
Although my problem was the result of the birth having him has helped me, my baby makes it all worthwhile
Not alone
I am encouraged by knowing that there are many other mothers…
Love
My loving family have been my rock
Blessings
I keep reminding myself about the gift of my child
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 10

11. 4/6/ :22 PM
Word Picture;
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 11

12. 4/6/ :22 PM
Conclusions
Bowel incontinence as a result of an injury sustained during childbirth is common and unknown by the medical profession or the lay public
This is an unspoken taboo
This is a specific ‘syndrome’
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION. 12