Background: Anal incontinence, defined as the involuntary loss of fecal material rnor flatus once in a week or more. It ranges in severity from an occasional rninvoluntary leakage of stool or flatus to a complete loss of bowel control. Thernoverall prevalence in the population is reported to be approximately 8.3%. It isrnassociated with reduced quality of life, negative psychogenic effects, and socialrnstigma, yet many women do not report their symptoms or seek treatment. Forrnchildbearing women Obstetric anal sphincter injury (OASIS) is a well-known risk rnfactor for AI. However, only half the cases of AI after childbirth can be attributedrnto OASIS. The other half may in part be caused by clinically unrecognizedrnsphincter injury visible on ultrasound (occult OASIS) or by chronic pudendarnneuropathy. rnBecause the long-term success of primary sphincter repair in resolving analrnincontinence is reported to be as low as 44%, it is important for health carernproviders to reduce trauma to the perineum during the second stage of labor tornavoid anal sphincter damage. In addition, postpartum care and follow up shouldrnnot overlook detection and treatment of anal incontinence. rnStatement of the problem : The overall prevalence of anal incontinence in rnchildbearing wome n ranges from 7% to 15% according to some literatures. Lessrnthan 3% of women who do self-report fecal incontinence will have this diagnosis rnrecorded in their medical record. But the real figure of the problem in ourrnpopulation is unknown. The most common risk factor is OASIS which occursrnduring child birth. Despite the anticipated magnitude of this public health problem,rnthere is limited data on the prevalence of AI after childbirth in our country.rnRationale of the study : Obstetrician â€“ gynecologists are in a unique position tornidentify women with anal incontinence because pregnancy, childbirth, obstetricrnanal sphincter injuries (OASIS), and pelvic floor dysfunction are important riskrnfactors that contribute to anal incontinence in women. Thus, this study is meant tornidentify the magni tude of AI, associated factors and increase our diagnosis of AIrnand suggest possible interventions to prevent the condition. rnObjectives: To A ssess Prevalence of Anal I ncontinence after vaginal delivery atrn6weeks postpartum in three selected teaching hospitals (BLH, GMH and ZMH) inrnAddis Ababa, Ethiopia, 2021. rnMethods: A prospective cross sectional study was done to assess the prevalence ofrna nal incontinence after 6 weeks of vaginal delivery. The study participants will bernthose women who gave birth through vagin al delivery. Sample sizes of 384 womenrnwere studied. The data were collected through questionnaire developed using rnInternational Consultation on Incontinence Questionnaire on Urinary Incontinence rnâ€“ Short Form (ICIQ-UI-SF) and risks factors associated with anal incontinencernmentioned in different literatures, immediat ely after delivery and 6 weeks later.rnAfter data collection, each questionnaire was checked for completeness based on rnthe code given during data collection. Data were entered in to SPSS version 20.5 rnstatistical package. Descriptive statistics like frequency, tables, graphs andrndescriptive summaries were used to describe the independent variables. Thernassociation of anal with independent variables is analyzed individually by binaryrnlogistic analysis and final association between dependent and independent variablernis analyzed by multiple regression analysis. rnResult : The prevalence of anal incontinence at 6 weeks of vaginal delivery wasrn8.6%. Accordi ng to bivariate analysis result, fetal presentation (vertex} , mode ofrndelivery (forceps) , d uratio n of second stage of labor (>120minutes) , peri nial te ar rnwere significantly associated with AI. After controlling the effect of confound ing rnfactors ( variables) , multiple logistic re gression analysis revealed that perineal tearrnis signi ficantly associated with AI ( AOR êžŠ 7.641; 95% CI (1.443, 40.453 ) P =0.17 , rnand those mothers had second degree of perinatal tear with ( AOR êžŠ 5.344; CI rn(1.144, 25.635) P=0.36, had significant association with AI.rnConclusion and recommendation: The prevalence of AI at 6 weeks of vaginal rndelivery was 8.6%. Perineal tear was significantly associated with AI, especiallyrnwith increasing degree of perineal tear. Thus, it is important to prevent perineal tear.rnIn addition, creating awareness about AI and making integral part of postpartumrnfollow is necessary.