J van Bavel, et al. - Researchers sought to determine risk factors, including mediolateral episiotomy, for the recurrence of obstetric anal sphincter injury (rOASI) via performing a population‐based cohort study. The cohort comprised 391,026 term women; of these, 9,943 women had an OASI in their first delivery, and had a second vaginal delivery of a life born infant in cephalic position. The rate of rOASI of 5.8% was reported. A higher rate of OASI in the next delivery was observed among women with a history of OASI. Per multivariate analysis, statistically significant risk factors for rOASI were birth weight ≥ 4000 grams and duration of 2nd stage ≥ 30 minutes. A statistically significant lower rate of rOASI was observed in spontaneous vaginal delivery and in operative vaginal delivery in correlation with mediolateral episiotomy.