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Mr Chris Barnick worked as a speaker and co-facilitator on the QSSS course at the Excel centre 16/6/2019.

QSSS is a new worldwide initiative to improve Quality and Safety in the Second Stage.

The aim of this course is to improve decision making in this crucial part of pregnancy and delivery and to train doctors around the world in the safe management of labour and in the use of the ventouse and forceps for safe vaginal delivery of babies in women who are in advanced stages of labour.

Around the world we have seen a dramatic rise in Caesarean Section rates. Even in low and middle income settings Caesarean section rates are between 40% and 90% when women are delivered in specialist obstetric hospitals. Whilst there are many reasons for this, one factor that has been identified is that doctors are loosing the skills necessary to deliver women using Ventouse and Forceps and are not confident in managing the second stage. As a result of this women are having emergency Caesarean sections late in labour and in the second stage. These Caesareans are the most high risk and may lead to excessive vaginal bleeding, infection, trauma and long term fistula formation. In addition to this they may have consequences for future pregnancies with an increased risk of Placenta accreta and premature delivery.

We feel that this is really important work. We had over 50 doctors from around the world attending the course with 5 facilitators lecturing, going through case scenarios and hands on training, using models which have been specially designed for this purpose.

We have had excellent feedback from the course and we have plans to repeat it in Chicago, Lahore, Calcutta and Cairo.