George Attilakos is a Consultant in Obstetrics and Fetal Medicine at University College London Hospital with a special interest in multiple pregnancies, fetoscopy and fetal surgery. He led the first UK randomised trial of the Kiwi Omnicup and co-developed the ROBuST course for which he was the first RCOG Convenor. He is the clinical lead for obstetrics at UCLH and the lead obstetrician for the North Central London Local Maternity and Neonatal System. Sharon Jordan has been a Senior Delivery Suite Midwife in North Bristol NHS Trust for over 30 years. She has supervised, trained and mentored generations of obstetricians learning how to safely perform assisted vaginal births, and she has always promoted keeping women at the heart of any birth experience. Michele Mohajer is Consultant in Obstetrics and Fetal Medicine at the Shropshire Women & Children's Centre and the Royal Shrewsbury Hospital, Shrewsbury and Telford Hospital NHS Trust. Dr Mohajer is passionate about high-quality training in assisted vaginal birth and codeveloped the first simulation-based training package for OVB, approved by the RCOG. Glen Mola is Professor and Head of Obstetrics and Gynaecology at the School of Medicine and Health Sciences, University of Papua New Guinea. Professor Mola is former President of the Pacific Society for Reproductive Health and received the Order of Australia in 2023 for distinguished service to obstetrics and gynaecology, reproductive health research and medical education in the Pacific region. Professor Mola supervises an obstetric unit that cares for over 15,000 births per year and achieves the lowest perinatal mortality rate in the LMIC world. Stephen O'Brien is Consultant in Obstetrics and Fetal Medicine at Southmead Hospital, North Bristol NHS Trust. He is an international expert in assisted vaginal birth and is the current RCOG national lead for assisted birth training. In addition to completing a PhD in assisted birth, he has published original research, reviews and calls to action for better training, tracking and monitoring of assisted birth techniques. Dimitrios Siassakos is Professor of Obstetrics at University College London Hospitals NHS Foundation Trust. He has led the development and dissemination of regional, national and global training courses to improve management of obstetric emergencies, operative birth (ROBUST, ART&CRAFT) and bereavement care (SUPPORT). He leads a comprehensive portfolio of research in stillbirth care and prevention, operative birth and technology enhanced care, with more than £40 m grants.

'A solution to the challenge of reducing maternal and neonatal morbidity and mortality during childbirth is to perfect the art of assisted birth by simulation training. ROBuST addresses this much-needed knowledge in this arena. This well-written book with clear illustrations, tables and clinical pathways is by a team of globally recognised experts who perform, train and research in assisted births and have done so for decades. This is an excellent contribution and must be read and used to provide safe and respectful maternity care.' Sir Sabaratnam Arulkumaran, PhD DSc FRCS FRCOG Professor Emeritus of O&G, St George's University of London Past President RCOG, BMA and FIGO

• List of Contributors; Preface; List of Abbreviations; 1. Trends in assisted vaginal birth and future practice Stephen O'Brien, George Attilakos, Kim Hinshaw and Dimitrios Siassakos; 2. Indications and assessment for assisted vaginal birth Deirdre Murphy and Meenakshi Ramphul; 3. Non-technical skills Rachna Bahl and Bryony Strachan; 4. Vacuum-assisted birth Glen Mola, Stephen O'Brien and Aldo Vacca; 5. Non-rotational forceps delivery Kim Hinshaw and Shilpa Mahadasu; 6. Rotational forceps Karl Oláh; 7. Caesarean section at full cervical dilatation Patrick O'Brien and Sadia Bhatti; 8. Medico-legal aspects of assisted vaginal birth (AVB) Milena Petrovic, Dimitrios Siassakos and Derek Tuffnell; 9. Analgesia and anaesthesia for assisted vaginal birth Rowena Pykett, George Bugg and David Levy; Index.

George Attilakos is a Consultant in Obstetrics and Fetal Medicine at University College London Hospital with a special interest in multiple pregnancies, fetoscopy and fetal surgery. He led the first UK randomised trial of the Kiwi Omnicup and co-developed the ROBuST course for which he was the first RCOG Convenor. He is the clinical lead for obstetrics at UCLH and the lead obstetrician for the North Central London Local Maternity and Neonatal System. Sharon Jordan has been a Senior Delivery Suite Midwife in North Bristol NHS Trust for over 30 years. She has supervised, trained and mentored generations of obstetricians learning how to safely perform assisted vaginal births, and she has always promoted keeping women at the heart of any birth experience. Michele Mohajer is Consultant in Obstetrics and Fetal Medicine at the Shropshire Women & Children's Centre and the Royal Shrewsbury Hospital, Shrewsbury and Telford Hospital NHS Trust. Dr Mohajer is passionate about high-quality training in assisted vaginal birth and codeveloped the first simulation-based training package for OVB, approved by the RCOG. Glen Mola is Professor and Head of Obstetrics and Gynaecology at the School of Medicine and Health Sciences, University of Papua New Guinea. Professor Mola is former President of the Pacific Society for Reproductive Health and received the Order of Australia in 2023 for distinguished service to obstetrics and gynaecology, reproductive health research and medical education in the Pacific region. Professor Mola supervises an obstetric unit that cares for over 15,000 births per year and achieves the lowest perinatal mortality rate in the LMIC world. Stephen O'Brien is Consultant in Obstetrics and Fetal Medicine at Southmead Hospital, North Bristol NHS Trust. He is an international expert in assisted vaginal birth and is the current RCOG national lead for assisted birth training. In addition to completing a PhD in assisted birth, he has published original research, reviews and calls to action for better training, tracking and monitoring of assisted birth techniques. Dimitrios Siassakos is Professor of Obstetrics at University College London Hospitals NHS Foundation Trust. He has led the development and dissemination of regional, national and global training courses to improve management of obstetric emergencies, operative birth (ROBUST, ART&CRAFT) and bereavement care (SUPPORT). He leads a comprehensive portfolio of research in stillbirth care and prevention, operative birth and technology enhanced care, with more than £40 m grants.

'A solution to the challenge of reducing maternal and neonatal morbidity and mortality during childbirth is to perfect the art of assisted birth by simulation training. ROBuST addresses this much-needed knowledge in this arena. This well-written book with clear illustrations, tables and clinical pathways is by a team of globally recognised experts who perform, train and research in assisted births and have done so for decades. This is an excellent contribution and must be read and used to provide safe and respectful maternity care.' Sir Sabaratnam Arulkumaran, PhD DSc FRCS FRCOG Professor Emeritus of O&G, St George's University of London Past President RCOG, BMA and FIGO

• List of Contributors; Preface; List of Abbreviations; 1. Trends in assisted vaginal birth and future practice Stephen O'Brien, George Attilakos, Kim Hinshaw and Dimitrios Siassakos; 2. Indications and assessment for assisted vaginal birth Deirdre Murphy and Meenakshi Ramphul; 3. Non-technical skills Rachna Bahl and Bryony Strachan; 4. Vacuum-assisted birth Glen Mola, Stephen O'Brien and Aldo Vacca; 5. Non-rotational forceps delivery Kim Hinshaw and Shilpa Mahadasu; 6. Rotational forceps Karl Oláh; 7. Caesarean section at full cervical dilatation Patrick O'Brien and Sadia Bhatti; 8. Medico-legal aspects of assisted vaginal birth (AVB) Milena Petrovic, Dimitrios Siassakos and Derek Tuffnell; 9. Analgesia and anaesthesia for assisted vaginal birth Rowena Pykett, George Bugg and David Levy; Index.

George Attilakos is a Consultant in Obstetrics and Fetal Medicine at University College London Hospital with a special interest in multiple pregnancies, fetoscopy and fetal surgery. He led the first UK randomised trial of the Kiwi Omnicup and co-developed the ROBuST course for which he was the first RCOG Convenor. He is the clinical lead for obstetrics at UCLH and the lead obstetrician for the North Central London Local Maternity and Neonatal System. Sharon Jordan has been a Senior Delivery Suite Midwife in North Bristol NHS Trust for over 30 years. She has supervised, trained and mentored generations of obstetricians learning how to safely perform assisted vaginal births, and she has always promoted keeping women at the heart of any birth experience. Michele Mohajer is Consultant in Obstetrics and Fetal Medicine at the Shropshire Women & Children's Centre and the Royal Shrewsbury Hospital, Shrewsbury and Telford Hospital NHS Trust. Dr Mohajer is passionate about high-quality training in assisted vaginal birth and codeveloped the first simulation-based training package for OVB, approved by the RCOG. Glen Mola is Professor and Head of Obstetrics and Gynaecology at the School of Medicine and Health Sciences, University of Papua New Guinea. Professor Mola is former President of the Pacific Society for Reproductive Health and received the Order of Australia in 2023 for distinguished service to obstetrics and gynaecology, reproductive health research and medical education in the Pacific region. Professor Mola supervises an obstetric unit that cares for over 15,000 births per year and achieves the lowest perinatal mortality rate in the LMIC world. Stephen O'Brien is Consultant in Obstetrics and Fetal Medicine at Southmead Hospital, North Bristol NHS Trust. He is an international expert in assisted vaginal birth and is the current RCOG national lead for assisted birth training. In addition to completing a PhD in assisted birth, he has published original research, reviews and calls to action for better training, tracking and monitoring of assisted birth techniques. Dimitrios Siassakos is Professor of Obstetrics at University College London Hospitals NHS Foundation Trust. He has led the development and dissemination of regional, national and global training courses to improve management of obstetric emergencies, operative birth (ROBUST, ART&CRAFT) and bereavement care (SUPPORT). He leads a comprehensive portfolio of research in stillbirth care and prevention, operative birth and technology enhanced care, with more than £40 m grants.

'A solution to the challenge of reducing maternal and neonatal morbidity and mortality during childbirth is to perfect the art of assisted birth by simulation training. ROBuST addresses this much-needed knowledge in this arena. This well-written book with clear illustrations, tables and clinical pathways is by a team of globally recognised experts who perform, train and research in assisted births and have done so for decades. This is an excellent contribution and must be read and used to provide safe and respectful maternity care.' Sir Sabaratnam Arulkumaran, PhD DSc FRCS FRCOG Professor Emeritus of O&G, St George's University of London Past President RCOG, BMA and FIGO

• List of Contributors; Preface; List of Abbreviations; 1. Trends in assisted vaginal birth and future practice Stephen O'Brien, George Attilakos, Kim Hinshaw and Dimitrios Siassakos; 2. Indications and assessment for assisted vaginal birth Deirdre Murphy and Meenakshi Ramphul; 3. Non-technical skills Rachna Bahl and Bryony Strachan; 4. Vacuum-assisted birth Glen Mola, Stephen O'Brien and Aldo Vacca; 5. Non-rotational forceps delivery Kim Hinshaw and Shilpa Mahadasu; 6. Rotational forceps Karl Oláh; 7. Caesarean section at full cervical dilatation Patrick O'Brien and Sadia Bhatti; 8. Medico-legal aspects of assisted vaginal birth (AVB) Milena Petrovic, Dimitrios Siassakos and Derek Tuffnell; 9. Analgesia and anaesthesia for assisted vaginal birth Rowena Pykett, George Bugg and David Levy; Index.