Role of training to reduce perineal trauma at an organsiational level

Abstract

In this chapter a process of changing clinical practice is presented with help of change management theory. The chapter is based on experiences from Norwegian hospitals in implementing a change in clinical practice during second stage of labour to reduce the incidence of obstetric anal sphincter injuries (OASIS). Training and educating Norwegian midwives and doctors on the labour wards to protect perineum during second stage of labour achieved the reduced incidence of OASIS. The educational programme included the entire staff involved in intra-partum care, both doctors and midwives, regardless of their length of experience in maternity practice. It is well recognised that educational programmes aiming to change an existing practice to a new method is a challenging process, hence, enthusiasm, leadership and resources are paramount.