Calling for views on impacted fetal head at caesarean section

By Wendy Randall, Consultant Midwife Oxford Midwives Safety

Share your views on impacted fetal head at caesarean section - we would like to hear from anyone involved in managing and responding to emergencies in obstetric theatres.

You are invited to complete a short survey of your views on the management of, and training for, impacted fetal head at caesarean section.

Over recent years, there has been a sharp increase in reports of perinatal brain injury associated with impacted fetal head (IFH) at caesarean section. IFH is an obstetric emergency, where the baby’s head is low and fixed in the mother’s pelvis at the time of caesarean section. These are technically challenging births associated with significant risks to both mother and baby. Despite this, there is no consensus for how best to manage these births, nor any evidence-based training. This has led to a lack of confidence amongst maternity staff and potentially harmful care in some circumstances.

The Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Midwives (RCM) and THIS Institute at the University of Cambridge are working together to address these deficits and build consensus for best practice. Through evidence reviews, interviews with all maternity staff involved with emergencies in obstetric theatres, and observation of simulated caesarean sections, prototype tools to support management and training have been developed. We hope that implementation of these tools and multi-professional training for the whole theatre team will help to prevent injuries in childbirth, as has been the case with other obstetric emergencies such as shoulder dystocia.

We want to ensure that these tools meet the needs of those who work in maternity care. The survey asks about the members of the multidisciplinary team who may require training in the management of impacted fetal; the wording used to communicate the emergency; how they would like to see training delivered; and, questions on techniques used to manage an impacted fetal head, including some questions specifically relating to the vaginal push method.

We know that maternity staff have valuable contributions to make, and we want to benefit from your expertise and experience to optimise the approach. This survey is the first step in seeking your views and we would like to hear from anyone involved in managing and responding to these emergencies. The whole activity should take up to 15 minutes.

We seek to better support clinicians by providing accessible guidance and an effective and safe form of training, co-designed with maternity staff, women/people and birth partners.

Further information:

  • You can access the survey via the Thiscovery online platform. You will be asked a small number of questions about your views on impacted fetal head at caesarean section. We will ask you to fill out some demographic information and invite you to participate in future activities to do with this project, should you wish to. This survey should take no longer than 15 minutes to complete.
  • Participation in this project is entirely voluntary. If at any time you decide you no longer want to take part, please let the research team know at [email protected].
  • Your confidentiality will be maintained at all times.