Operative vaginal birth simulation training for junior obstetricians

Around 80,000 women have an operative vaginal birth (OVB) in the UK each year. However, when performed with poor technique, the procedure can cause significant harm, such as vaginal tearing or facial damage to babies.  

This project from North Bristol NHS Trust aimed to address this issue by implementing structured, locally-delivered simulation training to junior obstetricians at four West of England maternity units. The aim was to increase the success of OVB by improving the practical obstetric skills of trainees.

This was the first attempt to systematically implement and evaluate a training package for OVB in more than one centre anywhere in the world. The training package was developed by a multi-disciplinary team of obstetricians and midwives in close cooperation with the Royal College of Obstetricians and Gynaecologists (RCOG).

Training has now been implemented in three sites, delivering eight training courses to over 40 doctors, and potentially influencing the birth experiences of over 2,200 women.

One site has been unable to implement the training, due to a lack of enthusiasm and buy-in from the local team. As a result, project timelines have been extended to allow the collection of balanced and meaningful data from the remaining sites. Data are currently being collated, cleaned and analysed in order to evaluate the effects on women and their babies.

The project team is looking to be able to quantify the impact of their intervention and share their learning with other quality improvement and patient safety initiatives. Should the training package prove beneficial, the RCOG has committed to making it mandatory for all UK maternity units.

Contact information

For more information about this project, please contact Dr Stephen O'Brien, Clinical Research Fellow, Southmead Hospital and University of Bristol.