Optimal clinical parameters for Odon Device use
The Odon Device was able to successfully assist births in all fetal positions. The midwives were particularly positive about the way the device could deliver a baby in the occipito-posterior position.
M9: ‘I think, probably, it could be quite universal as an instrumental device. It didn’t seem to matter whether the baby was OA or OP…’
As experience with the device increased, it became apparent that the device could be used comfortably without a regional anaesthetic and it repeatedly reported to be better tolerated than bladder emptying by urethral catheterisation:
D2: ‘She actually found the catheterisation more uncomfortable than putting on the Odon Device with no analgesia at all.’
Conversely it became apparent that for women with fetal station at spines or a more complex presentation (such as brow or nuchal arm) the device was less likely to be successful:
D3: ‘On examination, baby’s head was asynclitic, deflexed, occiput lateral, at the spines… in the future, I wouldn’t apply that, and I would tentatively think about Kiellands but I suspect I wouldn’t have been able to apply Kiellands and she’d have had a section anyway.’[unsuccessful Odon-emergency Caesarean section]D1: ‘So, it was direct OP at the spines, and it was almost coming to a brow, I could feel the orbital ridges…I was thinking, “Oh, I’m really not sure that this is going to work.”…I didn’t feel that wasn’t a failed Odon, that was a baby that was never going to come out vaginally.’ [unsuccessful Odon-failed rotational forceps, emergency Caesarean section]
It was observed that the qualitative interviews that enabled the operators to reflect on their most recent births and in some cases led to re-simulation of the birth they had just performed to try and understand why the device may have been unsuccessful.