Asian Women in England Face Higher Rates of Severe Birth Injuries, NHS Data Shows
Asian women in England experienced significantly higher rates of third- and fourth-degree tears during childbirth in 2023-24, with 2,831 cases per 100,000 deliveries compared to 1,473 for white women and 1,496 for black women, according to NHS data obtained via FOI.
These third- and fourth-degree tears, also known as obstetric anal sphincter injuries (OASI), represent the most severe form of vaginal birth injury. While up to 90% of women experience some form of tearing during delivery, these severe tears can lead to lasting complications such as bowel incontinence, post-traumatic stress disorder, and chronic pain.
The increased risk for Asian women is described as multifactorial, involving anatomical and physiological differences as well as systemic issues, though the exact reasons remain not fully understood. Frontline healthcare staff awareness is inconsistent; many women have reported that their midwives or doctors were unaware of the higher risk faced by Asian women.
Advocates and organizations such as MASIC and the Birth Trauma Association are calling for improved antenatal counselling that includes personalised risk communication delivered with culturally and linguistically appropriate information. Such measures aim to better inform expectant mothers and improve maternal outcomes.
The rate of severe tears has risen overall, increasing from 25 per 1,000 births in June 2020 to 29 per 1,000 in June 2025, marking a 16% rise.
An NHS spokesperson stated that the service is committed to providing safe, high-quality, and equitable maternity care, and to addressing disparities affecting Asian women and other communities.
