Anal sphincter injuries are detected in 25% of women after birth when they are carefully re-examined by a skilled obstetrician; however, these injuries were only found 11% of the time on a routine initial exam. Sphincter injury is the most common cause of fecal incontinence in women and can severely diminish their quality of life leading to substantial personal and financial damage. The vast majority of obstetric anal sphincter injuries can be detected clinically by a careful exam right after delivery. It is standard practice to repair a damaged anal sphincter immediately or within 24 hours of delivery. Delayed diagnosis and repair lead to life long problems with fecal incontinence.