Authors’ reply to Datta

Datta mentions the association between race or ethnicity and obstetric anal sphincter injury (OASI).12 Several studies have reported higher rates of OASI in Asian women—between 1.5 and 3.0 times as high as in white women—in high income countries such as Australia,3 Canada,4 Norway,5 the United Kingdom,6 and the United States.7 These higher rates persist even after adjustment for operative vaginal delivery and episiotomy. By contrast, rates of OASI among Asian people residing in Asia are not higher.89 The increased risk of OASI among Asian people should be considered when communicating the risks and benefits associated with the different options for second stage operative delivery. In the Canadian context, if the rates of OASI among spontaneous vaginal, forceps, and vacuum deliveries in Asian women were 1.5 times as high, they would be 4.2%, 32.3%, and 17.6%, respectively, and these rates would be even higher among those birthing for the first time….
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