Developing a postnatal questionnaire to understand ethnic minority women’s experiences with obstetric anal sphincter injuries: A pilot cross-sectional study

OBJECTIVE: Women from ethnic minority groups have higher rates of obstetric anal sphincter injuries (OASI) and often face barriers to follow-up care. This study aimed to design and pilot a questionnaire to explore ethnic minority women's postnatal experiences after OASI, identify barriers and facilitators to attending specialist perineal clinics, and assess the feasibility of this approach to inform a future mixed-methods study. METHODS: The questionnaire was co-designed with input from community stakeholders and piloted among three groups at a UK hospital serving a large ethnic minority population: women in the postnatal ward (n = 10), women attending a specialist perineal clinic (n = 10), and women who were invited but did not attend the clinic (n = 9). Quantitative data were analyzed descriptively, and qualitative data were analyzed using Braun and Clarke's thematic analysis framework. RESULTS: Most participants were of Pakistani ethnicity (15/29, 52%). Non-attenders reported greater barriers including perceived impact of ethnicity and language on care, lower awareness of tear type, and limited communication with healthcare providers. Many in this group lacked recall of key information or engagement with physiotherapy or clinic services. Clinic attendees reported more positive experiences and understanding of their care. CONCLUSION: This pilot questionnaire demonstrated feasibility and highlighted significant informational, cultural, and language barriers affecting postnatal care engagement among ethnic minority women after OASI. Further research with larger and more diverse samples, including translated and validated materials, is needed to refine the tool and inform interventions enhancing equity in postnatal care.