Recruitment of the sites is complete, with both a Midwifery and an Obstetric Champion volunteering to lead the programme from within each hospital. Support from local clinical champions, opinion leaders and professional organisations, as well as patient and public involvement and continuous monitoring and feedback, will help ensure that interventions are acceptable to women and health care professionals.
The programme has run for 2.5 years. The evaluation of the programme includes evaluation of the impact of the OASI care bundle on clinical practice and clinical outcomes. Results will be shared through publications.
This project focuses on OASI resulting from labour and vaginal birth. The project excludes the management and prevention of OASI resulting from gynaecological/urological procedures. It also excludes considerations on repair techniques and related co-morbidities.
The programme included the following activities:
Outputs of the OASI project
Analysis of secondary care data
- Edozien L, Gurol-Urganci I, Cromwell D, Adams E, Richmond D, Mahmood T, van der Meulen J.Impact of third- and fourth-degree perineal tears at first birth on subsequent pregnancy outcomes: a cohort study. BJOG. 2014 Jul 9. doi: 10.1111/1471-0528.12886.
- Gurol-Urganci I, Cromwell DA, Edozien LC, Mahmood TA, Adams EJ, Richmond DH, et al. Third- and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors.BJOG 2013;120:1516–25.
OASI Care Bundle
Following the OASI ‘Summit’ held at the RCOG on 1 May 2014, the RCOG committed to reducing OASI throughout the UK.
The RCOG have been working with the Royal College of Midwives to increase awareness of OASI incidence and risks among health professionals involved in maternity care and to develop tools to improve the prevention and management of severe perineal tearing. A national group of experts have been involved in the development of the OASI Care Bundle.
The elements of the OASI bundle include informing each woman about OASI and what can be done to minimize her risk, performing an episiotomy (a cut in the perineum to assist birth and prevent tears) when required, using the hands to enable perineal protection at the time of birth and a thorough examination after birth to detect tears not all of which will be immediately obvious. All elements of the care bundle are underpinned by good communication with the woman before, during and after birth.
We have developed and piloted an intervention package which brings together the care bundle, a skills development module, and campaign materials. Over the next couple of years, we will be scaling up this project, implementing the intervention in 16 sites across Great Britain and looking at the outcomes over this period.
Find out more
For more information about the OASI care bundle, please OASICareBundle@rcog.org.uk or call +44 20 7772 6347.