Objective: To standardize obstetric simulation training curriculum on the main obstetrical emergencies in the Italian National Program for residents. Recruitment: experts all around the Country with proven experience in teaching Gynecology and Obstetrics, simulation activities and proven clinical experience in the management in labor complications and peripartum emergencies, participated at the study (SIMOBE Group). Setting: Specific Objective Structured Assessment of Technical Skills checklists were created or modified, and finally approved. Methods: Delphi study was conducted in 4 different rounds to reach a shared checklist for each emergencies Main outcome: Development of OSATS checklist for the major obstetric emergencies Results: A consensus on specific OSATS checklist has been reached in all the obstetrical emergencies. The level of appreciation for each OSATS has been considered good or excellent in most of the cases: shoulder systocia (around 82%), external cephalic version (around 94%), vacuum application (around 75%), management of abnormal CTG in labor (around 42%), post-partum hemorrhage (around 96%), reverse breech extraction (around 72%), Maternal collapse (around 94%), forceps vaginal application (around 76%), non-cephalic second twin delivery assistance (around 96%), assisted breech delivery (around 94%), third-fourth degree perineal laceration repair (around 82%) Conclusion: Development of OSATS checklists on the main obstetric emergencies is pivotal to provide standardized competencies to the personnel dedicated to childbirth.. The SIMOBE working group, recommends the use of these OSATS throughout the national territory.

Objective: To compare mothers’ satisfaction at birth and intrapartum care during COVID-19 pandemic compared to a pre-COVID cohort. Design: Prospective cohort study Setting: Low risk maternity unit in Northern Italy Population: Women who delivered during COVID-19 pandemic compared to a pre-COVID cohort recruited in the same setting in February-May, 2018. Methods: Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R) was used. Main Outcome Measures: Satisfaction at birth in relation to socio-demographic characteristics, obstetric history and intrapartum care variables. Results: 377 women were included (277 pre-COVID and 100 during COVID pandemic). A higher rate of induction [40%, COVID versus 25% pre-COVID, p 0.004], fewer active phases >12 h [6% COVID versus 15% pre-COVID, p 0.018] and more acceleration with oxytocin [35% COVID versus 24.9% pre-COVID, p 0.05] were found. No differences in terms of satisfaction at birth were reported (I-BSS-R mean 27.0, SD 5.3 versus mean 27.6, SD 6.1, p 0.34). Intrapartum variables that significantly reduced maternal satisfaction were the same in the two groups: epidural analgesia (p< 0.0001 in both groups), prolonged active phases (p < 0.0001 in both), oxytocin administration (p<0.0001 in both) and operative delivery (p 0.0009 versus p 0.0019). The lowest scores in COVID era were found in those who underwent induction of labor, active phases >12 h and CS in labor. Conclusions: No differences were reported concerning global satisfaction at birth, despite an increased rate of active intrapartum intervention. Keywords: Childbirth experience, COVID-19, intrapartum intervention