Objective: to test the hypothesis that PROMPT reduces permanent brachial plexus palsy and perinatal tears. Design: prospective / retrospective cohort study. Setting: Hanover Medical School, Germany. Population / Sample: a self-selected population. Methods: training period November 9 th 2017 until 31 st December 2019, control January 1 st 2004 until November 8 th 2017. Main outcome measures: shoulder dystocia, non-permanent and permanent brachial plexus injuries (BPI), perineal tears III°/ IV°, manual manoeuvres, and asphyxia. Results: there was a total of 22,640 births, shoulder dystocia increased from 48/18.031 (0.27%) to 23/4.609 (0.50%) (p=0.017), OR 1.88, 95%-CI [1.14; 3.09] whereas BPIs decreased from 7/48 (14.6%) to 1/23 (4.3%) (p=0.261). There was 1/7 (14.2%) of permanent BPI before and 0/1 (0%) case after. Perinatal asphyxia increased from 3/48 (6.3%) to 4/23 (17.4%) (p=0.23). However, adverse outcomes after one year were zero. McRoberts’ increased from 37/48 (77.1%) to 23/23 (100%) (p=0.013), OR 1.62, 95%-CI [1,33; 1,98] and internal rotation manoeuvres and manual extraction of the posterior arm from 6/48 (12.5%) to 5/23 (21.7%) (p=0.319). Episiotomies decreased from 5.267/18.031 (29.2%) to 836/4.609 (18.1%) (p<0.001) OR 0.54, 95 %-CI [0.49, 0.58], whereas perineal tears III°/IV° associated with shoulder dystocia increased from 1/48 (2.1%) to 1/23 (4.8%), (p=0.546). Vaginal operative deliveries remained constant (6.5% vs 7%). Conclusions: PROMPT significantly improves the management of shoulder dystocia and decreases permanent brachial plexus injuries, but not perinatal tears III°/IV°.