Introduction and Hypothesis <p>Obstetric anal sphincter injuries (OASIs) are associated with increased risk of postpartum complications, including short- and long-term dyspareunia and sexual dysfunction. The primary aim of this analysis is to evaluate whether engagement in a telehealth urogynecology consultation was associated with decreased sexual health concerns after OASIs.</p> Methods <p>This is an analysis of sexual health data, secondary outcomes from a prospective study comparing standard postpartum care versus standard postpartum care plus a telehealth urogynecology consultation. The analyzed outcomes were Female Genital Self-Image Scale (FGSI) and Female Sexual Function Index (FSFI-6) scores at 16 weeks postpartum. Chi-squared and <i>t</i> tests were used to compare groups.</p> Results <p>A total of 119 participants with OASIs completed the study (control group <i>n</i> = 62, intervention group <i>n</i> = 57). The intervention group had significantly improved FGSI scores (18.9 vs 20.4, <i>p</i> = 0.02). There was no significant difference on the FSFI-6 (12.0 vs 12.1, <i>p</i> = 0.90), with 77% of the control group and 81% of the intervention group (<i>p</i> = 0.66) classified as having female sexual dysfunction by the FSFI-6. In the telehealth consult group, only 28% of participants (<i>n</i> = 16) had resumed sexual activity, with 88% of those participants endorsing dyspareunia. Interventions reviewed during the telehealth consult included vaginal estrogen, use of lubricants, and pelvic floor physiotherapy.</p> Conclusions <p>A postpartum telehealth urogynecology consultation was associated with improved genital self-image but did not reduce sexual dysfunction as measured on the FSFI. These results highlight the significant impact that OASIs can have on sexual function, and the importance of postpartum evaluation and care to support patients after severe obstetric perineal trauma.</p>