[Delivery care in Sweden is safe: but there are challenges concerning teamwork and communication].

Abstract

Delivery care in Sweden is very safe, the incidence of maternal death is 5/100 000 and perinatal death <2/100 000. The perinatal death rate among babies born at or after week 41+0 decreased from 0.17 to 0.09% (p<0.001) and obstetric anal sphincter injuries have decreased from 3.5% to 2.6%; however interventions such as induction of labour increase. A national project to improve safety for newborns at delivery was initiated in 2007, engaging all delivery clinics in Sweden. The cooperative work process resulted in implementation of protocols, safety tools (SBAR; NEWS2) and intensified simulation training. The Swedish Pregnancy Register offers available data on pregnancy and delivery, enabling delivery clinics to assess results and direct improvement efforts. Still, challenges concerning teamwork and communication in difficult situations such as vacuum extraction and fetal surveillance with CTG need attention. Individualized support to »second victims« and continuous focus on phycological safety have the potential to further improve delivery care.