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Given the broad range of potential causes of complications from obstetric trauma, clinical and system reviews should be conducted to identify latent causes and determine appropriate recommendations.

Occurrences of harm are often complex with many contributing factors. Organizations need to:

  1. Measure and monitor the types and frequency of these occurrences.
  2. Use appropriate analytical methods to understand the contributing factors.
  3. Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.
  4. Have mechanisms in place to mitigate consequences of harm when it occurs.

To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the Hospital Harm Improvement Resources Introduction.

If your review reveals that your cases of OB Trauma are related linked to specific processes or procedures, you may find these resources helpful:

  • American College of Obstetricians and Gynecologists (ACOG). https://www.acog.org/
    • Prevention and Management of Obstetric Lacerations at Vaginal Delivery. ACOG Practice Bulletin, Clinical Management Guidelines for Obstetrician–Gynecologists. Number 198, September 2018.
    • Operative Vaginal Delivery. ACOG Practice Bulletin, Clinical Management Guidelines for Obstetrician–Gynecologists. Number 154, November 2015.
    • Vaginal Birth After Cesarean Delivery. ACOG Practice Bulletin, Clinical Management Guidelines for Obstetrician–Gynecologists. Number 2015, February 2019.  
  • Association of Women's Health, Obstetric and Neonatal Nurses. www.awhonn.org
  • Association of Ontario Midwives. https://www.ontariomidwives.ca/
  • Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair.  SOGC Clinical Practice Guideline. No. 330, December 2015.
  • Assisted Vaginal Birth. SOGC Clinical Practice Guideline. No. 381, June 2019.
  • Trial of Labour After Caesarean. SOGC Clinical Practice Guideline. No. 382, July 2019.