Reducing the incidence of obstetric anal sphincter injury: a multidisciplinary approach
Bea Chubb, Lauren Govier, Kerry TaylorBackground/Aims
Obstetric anal sphincter injuries are a severe form of perineal trauma affecting women during childbirth. This service improvement project's aim was to reduce obstetric anal sphincter injuries rates at an NHS trust hospital through implementation of evidence-based interventions, by introducing warm perineal compresses during second stage labour and improving staff confidence in obstetric anal sphincter injury prevention techniques.
Methods
A multidisciplinary team developed and delivered comprehensive training to 68 staff members at the trust, introduced warm compress equipment and created educational resources for clinicians. Evaluation included staff surveys to understand knowledge acquisition and confidence and comparison of obstetric anal sphincter injuries rates before and after implementation.
Results
Obstetric anal sphincter injury rates decreased from 2.5% to 1.4% ( P =0.0156), with the most significant reduction in forceps births (8.9% to 2.6%). Staff reported increased confidence in obstetric anal sphincter injuries prevention techniques and antenatal education.
Conclusions
This quality improvement initiative appears to have contributed to reduced obstetric anal sphincter injury rates through a combination of staff training and warm compress implementation.
Implications for practice
Ongoing monitoring and regular training updates are essential for sustained improvement.