The goal of this observational study is to learn more about the effect a pregnancy and delivery has on the function of the anal musculature.We will compare women who had a new delivery after suffering a severe tear in the anal musculature in their first pregnancy, with women who had two or more vaginal deliveries, but did not suffer such an injury.

The main questions we want to answer is:

• can the burden of a new pregnancy and delivery weaken the function of the repaired musculature in a way that might cause symptoms of anal incontinence later in life?
• can a tear in the anal musculature increase the risk of developing urinary incontinence and long term sexual dysfunction?
• should we recommend these women to have a caesarian section instead of a new vaginal delivery?

Participants will be asked to complete an electronic questionnaire with information regarding their pregnancies, deliveries and potential symptoms from anal incontinence, urinary incontinence and sexual dysfunction.

Researchers will compare these two groups to find out if a new vaginal delivery has a negative effect on the function of the anal musculature.

Inclusion Criteria:

• Sphincter group: Previous obstetric anal sphincter injury during vaginal childbirth in 2002-2018 and having a subsequent vaginal delivery without such injury
• control group: Two or more vaginal deliveries without obstetric anal sphincter injury

Exclusion Criteria:

• under 18 years
• consent incompetency
• Obstetric anal sphincter injury in subsequent pregnancies
• caesarian section in subsequent pregnancy

Study population will be women who had two or more vaginal deliveries at Oslo Universitetssykehus in the time period 2002-2018.

The participant data will only be available to the researchers in charge of this project