Our consumers expect personalised, experience-led care that reflects their individual needs and circumstances.
To do that, we need to commit to working more closely and constructively together and actively seeking consumer feedback on how we can improve.
The Operative Vaginal Birth (OVB) Safety Bundle is a model of care that provides tools and practices that support clinicians at every stage of the operative vaginal birth process. It allows health services to support safer birthing experiences for women, babies and maternity teams.
Key components of the safety bundle include:
By implementing the bundle, health services create a multidisciplinary approach to safer birthing centred on safety and best practices. With the right leaders championing change, we hope the tools we’ve developed will help spark real cultural change — towards safer care and a better experience for all.
Assisting the birth may be recommended if concerns arise in the second stage of labour, such as fetal distress, malposition, prolonged labour, or underlying health conditions. In these situations, there are two options that can be considered: operative vaginal birth (OVB) using instruments like forceps or ventouse, or a fully dilated caesarean section (FDCS). Both options come with higher risks of serious complications for both the mother and baby and need to be considered carefully.
To reduce these risks, obstetric guidelines worldwide provide clear prerequisites and procedural steps for OVB. However, serious safety events can occur due to poor adherence to these guidelines. Potential issues include loss of situational awareness, lack of escalation, inadequate safety systems, and inaccurate determination of fetal head position.
In this program, we provide our resources to assist other maternity services to implement our OVB safety bundle. We invite all centres to participate in prospective data collection to monitor and assess their clinical outcomes, with the main aim of developing a healthcare safety culture.
A series of poor outcomes from operative vaginal births (OVB) in Victoria prompted an investigation by the Consultative Counsel of Obstetric and Paediatric Mortality and Morbidity (CCOPMM). The investigation identified common issues such as inaccurate diagnosis of fetal position, breakdown in team communication, delays in escalation, and practices outside accepted safety guidelines.
In response, a multidisciplinary team at Monash Health developed, piloted, adapted, and rolled out the OVB Safety Bundle between 2021 and 2024. The initiative has demonstrated significant improvements in clinical outcomes, as well as the wellbeing of clinical teams, as documented in our current and forthcoming research publications. The bundle is in place across all four Monash Health maternity sites.
Over the pilot and roll-out period, we developed tools and resources to support our implementation and have transformed these into a comprehensive and adaptable training package to support other maternity services in implementing the bundle.
Read more about our current plans to roll out the bundle to maternity services in Victoria.
