Enhanced Recovery After Surgery (ERAS) pathways have been widely adopted across multiple surgical specialties and are associated with improved postoperative outcomes, including faster recovery, reduced length of hospital stay, decreased complication rates, and improved patient satisfaction. Within Obstetrics and Gynecology, standardized ERAS protocols have been established for cesarean delivery, gynecologic laparoscopic surgery, and gynecologic oncology procedures.

Despite these advances, there is currently no standardized ERAS protocol for the management of obstetric perineal lacerations. Third- and fourth-degree obstetric lacerations (obstetric anal sphincter injuries, OASIS) are associated with significant maternal morbidity, including pelvic floor dysfunction, fecal and urinary incontinence, dyspareunia, and long-term sexual dysfunction. Postpartum management strategies for these injuries vary widely between providers and institutions, potentially leading to inconsistent patient counseling, treatment, and outcomes.

Understanding current clinical practice patterns is a necessary first step toward the development of a standardized ERAS protocol for obstetric lacerations aimed at improving recovery, quality of life, and equity in postpartum care.

A questionnaire will be distributed electronically to Obstetrics and Gynecology residents, fellows, and attending physicians within ACOG District VII Providers. The survey will collect data on provider-reported management practices related to obstetric lacerations, including but not limited to:

• Pain management strategies
• Use of antibiotics
• Bowel regimen recommendations
• Bowel regimen recommendations
• Pelvic floor physical therapy referrals
• Postpartum counseling practices
• Follow-up and recovery recommendations

Participation will be voluntary and anonymous. Institutional Review Board (IRB) approval will be obtained prior to survey distribution.

Primary Objective: To characterize current postpartum management strategies for obstetric lacerations used by residents, fellows, and attending physicians at ACOG District VII.

Secondary Objectives:

• To identify areas of variability and potential gaps in current practice.
• To inform the development of a standardized ERAS-based protocol for obstetric anal sphincter injuries.
• To promote consistency and equity in postpartum care for patients with obstetric lacerations.