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Obstetric emergencies were the focus of the second multidisciplinary perinatal forum held by the West Midlands Perinatal Institute. Cord prolapse, placental abruption, uterine scar rupture and shoulder dystocia account for less than 4% of all deliveries. However, they are important to consider because many of the deaths associated with these emergencies are considered avoidable (CESDI, 1998; 1999). In dealing with these emergencies a coordinated, multidisciplinary approach is essential. Staff in delivery suites should have regular emergency drills and key personnel should have advanced life support obstetrics (ALSO) or managing obstetric emergencies and trauma (MOET) training. Good communication with parents is vital. This article covers the first three topics, the next issue considers shoulder dystocia.

The West Midlands Perinatal Institute has been set up to proactively address the highest perinatal mortality rates in England and Wales. One strategy employed by the Institute to facilitate and inform appropriate professionals of recent evidence and advances in practice, is the introduction of multiprofessional perinatal forums on topics related to modern perinatal care. These forums provide an oppportunity for the region's professionals to discuss and reflect on their practice in a non-threatening environment. This is the first article in a series of reviews of the West Midlands perinatal forums.

Personally held maternity records are used in many parts of the country. However, there is wide variation in the content and design and little consultation with what their main users feel the notes should contain. In the West Midlands, we have undertaken a major review of maternity notes and have produced a draft that has been undergoing region-wide consultation, and a field trial is in progress. We would now like to widen this consultation and ask for your ideas and feedback.

Although a relatively rare event, shoulder dystocia was directly responsible for up to 8% of intrapartum deaths (CESDI 1997; 1998) and two thirds had avoidable factors in their management. These findings and the epidemic of litigation cases associated with shoulder dystocia highlights the urgent need to review our practice and practice guidelines. This article considers some of the discussions arising from the multidisciplinary perinatal forum held by the West Midlands Perinatal Institute focusing on obstetric emergencies.