Multidisciplinary Approach to OASIS Birth Injuries

Discussion with Tracy Sher, Shereen Sairafi, Sarah Barker, & Tyler Muffly 


  • 2 hours 
  • NY CEUs available
  • For other states, check for reciprocation or individual application



  • Medical and Fitness Professionals
  • No pre-requisites
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What can I expect?

Here are some highlights this webinar will cover:

  • Risk factors for OASIS- 3rd and 4th degree tears: Birth weight (increased), posterior position, Asian ethnicity, labor induction or augmentation, epidural, forceps, vacuum.
  • Does perineal massage help prevent tears? Warm compresses seem correlated with decreasing OASIS (not grades 1-2). This seems the same for perineal massage. (Aasheim 2017).
  • How often should perineal massage be done? Start at weeks 34-35 weeks gestation. 2 x a week for 10 min. Doing it more frequently or longer doesn’t lead to better outcomes.
  • Does it matter how one pushes during childbirth? Lithotomy position (on back with legs up) has highest potential for OASIS. Side lying, squat, semi-recumbent, and all 4s better (61-66% intact perineum).
  • Open glottis breathing and awareness of gently bulging pelvic floor vs pushing and bearing down shortens second stage of labor and and reduction in ALL grades of tears.
  • Having a pelvic floor therapist instruct and assess for contract, relax, bulge of pelvic floor muscles before and after birth can potentially reduce injury and improve function.
  • In an an ideal world- it would make sense to do perineal massage, have awareness of how to strengthen the pelvic floor AND how to relax and gently bulge during contractions with open glottis, reduce chances of having inductions or forceps/vacuum.

Topics Covered:

Sarah Barket: Midwife/Delivery perspective
Types of tears, definitions and risks
Positions for birthing
Risk Factors for Tears 
Midwifery interventions to prevent OASIS
Tyler Muffly: Urogynecology Perspective
Anatomy/Physiology of Anal Sphincters and Defecation
Prevention of OASIS
Surgical Repair (Critical to catch at the time right after delivery!)
Evaluation of fecal issues after childbirth and OASIS
Shereen Sairafi: Pelvic Therapy Perspective
Evidence Regarding Perineum Massage - Antenatal and Postpartum
How to Educate Patients to Improve Outcomes
Pelvic Floor Exercise Considerations
Common Secondary Sequelae from OASIS
High Quality Immediate Postpartum Care
Determining Mode of Delivery Next Birth

What You Will Learn:

Upon completeion of this webinar, participants will be able to:

  • Understand how to prevent OASIS
  • Understand appropriate care for patients post-operatively 
Learn ways to problem solve a variety of sexual health issues.
Learn ways to problem solve a variety of sexual health issues.
Feel comfortable navigating psychosocial nuances while learning practical skills to do so. 

Do you want to watch THIS webinar and ALL of our other webinars for one yearly price? 

The Global Pelvic Health Alliance Membership offering features designed to help you grow your clinical skills and build your business. 
  • Webinars: an amazing set of webinars (like this one) that are all included in the membership with the ability to be present at the live recording and ask questions to the presenters.
  • Illustrations: We have an illustration that creates anatomy illustrations for us. We are constantly looking for ways of presenting the anatomy in ways that are more accurate and descriptive.
  • Handouts: Using the illustrations and an amazing team of colleagues to help review, we create a collection of handouts for you to use with your patients/clients!
  • Premiere Directory Listing: While anyone can have a free directory listing, GPHAM members get to have a profile picture, live links, and photo galleries to stand out. 
  • Global Pelvic Health Support Community: In addition to resources, you can also ask to join the private FB page with hundreds of multidisciplinary professionals from around the world to help you out!

Tracy Sher, PT, DPT, CSCS - Your Host

Tracy Sher is a pelvic physical therapist and is the founder of Pelvic Guru, Pelvic Guru Academy, and the Global Pelvic Health Alliance Membership. She is also an instructor for Pelvic Guru Academy, teaching Pudendal Neuralgia and Complex Pelvic Pain Solutions. 

Shereen Sairafi PT, DPT, WCS

Shereen Sairafi graduated from Boston University in 2013 with a doctorate of physical therapy. Since that time she has been working in the pelvic health field and advocating for broader access for patients with pelvic floor dysfunction. Six years ago she founded the pelvic health physical therapy program at Denver’s public health, safety-net hospital. Her clinical interests include rehabbing and preventing obstetric anal sphincter injuries, assisting patients in returning to all functional activities (including sex) pain free, and caring for gender diverse patients. 
In her free time she enjoys running, playing tennis, and perfecting her tahdig recipe. 

 Sarah Barker, MS, CNM

Sarah K Barker specializes in certified nurse midwife in Denver, CO and has over 6 years of experience in the field of medicine. She graduated from her medical school with her medical degree in 2016. She is affiliated with numerous hospitals in Colorado and more, including Denver Health Medical Center.

Tyler Muffly, MD

Dr. Tyler Muffly, MD is a Female Pelvic Medicine & Reconstructive Surgery Specialist in Denver, CO and has over 18 years of experience in the medical field. He graduated from Jefferson Medical College Of Thomas Jefferson University medical school in 2004. He is affiliated with Denver Health Medical Center. 


What is the Cancelation & Refund Policy?
Individual GPHAM webinars are non-refundable. 
For other courses, the option for a full refund is available within 48 hours of purchase, however it is non-refundable upon either of these conditions:
  • You have viewed more than 50% of the course material
  • You have already claimed your CE certificate
If you need additional assistance with a refund or course concern, please email
Will there be any part of this live course where I could be recorded?
Live participation parts of courses may be recorded live and screenshots maybe be taken by the instructor or the host. If your camera is on, your microphone is on, or you type comments in the comment section, your participation will be part of that recording. If you do not wish to be part of this recording, you will be responsible for keeping your video and audio recording OFF during any live recorded sessions. 
How can I use the handouts, videos, and course supplemental material?
You will be provided with online content and recordings of the course as well as slides and material related to the course. This material is for your personal use only.  Please do not use clips of video, screen captures, screenshots, or copying in any way, that you might be presenting it as your own (whether or not it is for financial gain). Sharing a screenshot to social media that is credited to the instructor and/or Pelvic Guru, LLC is acceptable. If you would like to use any of this content for an independent project, you need to discuss this directly with Pelvic Guru and the instructor of the course. 
Will I have to exercise or have a space to move for this course? 
Some of the Pelvic Guru Academy courses have sections in them in which you will have the option of doing movement at various levels. Understand that all physical therapy, rehabilitative, and strength training instruction and use of all facilities and equipment shall be done at you own risk, and please be physically and medically able to undertake any and all physical therapy, rehabilitative, and strength training instruction provided in the course.