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New procedures seek to lower birth injury rate

While doctors in delivery rooms have to rely upon their instincts, overconfidence can sometimes blind them to potential risks inherent in their practices. This overconfidence may also foster an environment where junior medical personnel do not feel empowered to speak up when they think there is a potential danger of death or injury during a birth.

A new program is showing potential to reduce birth injuries by enabling the entire delivery team to evaluate how they perform under a variety of potentially dangerous situations that can arise while a mother is giving birth. These trainings use a system of best practices called "care bundles" which the team practices using a lifelike pregnant training robot to simulate birth emergencies.

An article in the Wall Street Journal reviewing these new training initiatives highlights the five issues which cause most fetal injuries:

  • Failing to recognize that an infant is in distress
  • Inappropriately using labor inducing medications
  • Delay in initiating a C-section when needed
  • Improper use of vacuums and forceps
  • Failing to properly resuscitate a baby

The new protocols being developed in a pilot program are designed to reduce the negative results associated with these issues.

The program is being developed in two different hospital systems provides training using the birthing robot and then allows the entire team to review their actions and determine how a situation could have been better handled. Some participating hospitals are also issuing scorecards to doctors; praising those who follow the care bundle best practices and low marks to those who do not.

So far, the results appear to be promising. Over the course a year 16 hospitals using this program reduced fetal injuries by almost 12 percent. One hospital saw a drop of 50 percent in its infant mortality rate. Hopefully these practices can be standardized to help doctors and their staff across the country to provide the best possible care.

Source: Wall Street Journal "Delivering Results" Laura Landro, March 28, 2011

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