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Safe Instrumental Birth17973NSW257/1/2009 6:00:00 AMObstetrics & GynecologyAustraliaNew South Wales Department of Health (Australia)" The application of forceps or a vacuum in instrument births have the potential to cause serious harm to both the mother and baby, but any delay or hesitation has the potential for increased fetal morbidity and mortality. Fifteen incidents were reported in a three year period between 2004 and 2007. The key issues include procedure undertaken by inexperienced staff with lack of appropriate supervision, lack of understanding of existing vacuum birth protocol, lack of pathway to seek external advice or seek help from senior staff, procedure resulting in significant perineal trauma and lack of multidisciplinary team approach in instrumental birth. This alert includes actions to reduce risk."5/11/2020 2:12:39 AMMaternal death or serious disability associated with labour or delivery in a low-risk pregnancy while being cared for in a healthcare facility Décès ou grave invalidité de la mère Associated Conditions;Patient Safety Incident