An OASI Care Bundle, prepared by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM), has been viewed positively by two evaluation papers published in BJOG and BMJ Open.
The OASI Care Bundle aims to reduce the risk of women suffering severe perinatal tearing during childbirth.
Obstetric anal sphincter injury (OASI) can occur in 6 out of 100 births for first-time mothers and less than 2 in 100 births for women who have given birth vaginally before.
These injuries can have an impact on a woman’s mental and physical health.
The OASI Care Bundle was implemented in maternity care units by obstetric and midwifery champions and supported by multidisciplinary training and raising awareness of OASI.
Two papers evaluated the effectiveness of the care bundle as well as barriers and enablers to update.
The clinical results, published in BJOG, compared 2,800 singleton vaginal births that took place after implementation of the care bundle.
Results found that it reduced the rates of severe perineal tearing from 3.3% to 3.0% without affected rates of caesarean section or episiotomy rates, with an estimated reduction in tearing of 20% when taking into account women’s characteristics.
The BMJ open paper found that engagement, thorough awareness-raising and training was key to clinical buy-in and successful implementation.
The studies now mean the next phase of work will go ahead, OASI2, in the autumn of 2020 and will involve 10 of the original units that participated at the beginning, with an additional 20 new maternity units.
OASI2 will evaluate and compare different approaches to the implementation of the OASI Care Bundle to support wider adoption and sustainability.
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