This paper presents the control algorithm implanted on the childbirth simulator BirthSIM in order to provide training to novice obstetricians. The forceps extraction is an obstetric manipulation learned by experience. However, nowadays the training is mainly provided during real childbirths. This kind of training could lead to dramatic consequences due to the lack of experience of some operators. This paper explains the approach that has been used to simulate the dynamic process of a childbirth on the BirthSIM simulator. We especially focus on one procedure that reproduces a difficult instrumental delivery. The recorded tractive force to extract the fetus corresponds to the literature results that confirm the realism of the simulator. The novice results emphasize the need of a childbirth simulator in order to gain initial experience without any risks.

This paper presents a new available feature on the childbirth simulator BirthSIM. This feature offers a risk- free training for novice obstetricians to proceed to forceps extractions. The different forces involved during deliveries are described and modeled. The choice of a control strategy in order to reproduce all these forces is explained and argued. This paper also introduces the concepts of simple and double synchronization during deliveries. Its application allows to minimize the amount of forces exerted with forceps during an instrumental delivery to make it as safe as possible. Simulations of forceps extraction carried out by two junior obstetricians are provided and analyzed. The corresponding results are compared to the literature and to the results obtained by an expert.

Today, medical simulators are increasingly gaining attraction in clinical settings. These tools allow physicians to visualize the positions of organs, plan surgical interventions, and carry out more comprehensive post operative monitoring. A childbirth simulator provides a risk-free training and research tool for comparing various techniques that use obstetrical instruments or validating new methods. This paper presents a new teaching method to place forceps blades for obstetricians using an instrumented childbirth simulator. The proposed method is based on a physical simulator coupled with a computer graphics interface. Another aspect of this paper is to provide understanding marks to quantify the progression during a training. A first one allows to study the path in space and to quantify their repeatability, a second one allows to compute the error to a reference gesture defined by an expert. Both marks are complementary. Two novices were trained and they manage to have a more repeatable gesture and above all to become closer to a reference gesture, i.e. to reduce the injury linked to the use of forceps during instrumental deliveries.

Birth represents for each human being one the most wonderful days of his life but also one of the most dangerous. Being born in safe conditions requires to be surrounded by professionals who acquire a rigorous knowledge of diagnostic and therapeutic procedures. Nowadays, midwives and obstetricians learn mainly in delivery ward during real childbirths. For difficult childbirths, the use of obstetrical instruments (forceps, spatulas or vacuum extractors) is unavoidable. However, the use of such instruments increases the risks of lesions for the mother and the fetus. In practical, only clinical experience acquired in the delivery ward enables these risks to be reduced. Nowadays, simulators in medicine have a real appeal in the medical environment. These tools enable doctors to visualize the position of the organs in the human body, to plan their movements or to carry out a more complete post operational control. A birth simulator provides a training tool and a research tool to compare various techniques for the use of obstetrical instruments or to validate new methods. It is in this context that we have developed, in collaboration with researchers and medical doctors, a new type of instrumented forceps to offer new solutions for training obstetricians for the safe use of obstetrical forceps delivery. The main contributions of this paper are the design of instrumented forceps coupled with the BirthSIM simulator and the path analysis during the forceps blades placement. This analysis leads to the comparison of the repeatability of the movement between novice obstetricians and expert obstetricians. The results highlight the lack of teaching tool to correctly train the novice obstetricians

This paper presents some new automatic procedures for the BirthSIM childbirth simulator. BirthSIM is able to simulate the uterine contractions and the mother's voluntary efforts, this enables the operator to synchronize these two types of efforts during a normal childbirth, or to synchronize these two efforts with the operator's tractive instrumental effort during childbirth using obstetric instruments. One originality of the BirthSIM simulator is to allow the medical team to acquire a better understanding of the application of these two synchronization concepts. With the aim of implanting various childbirth procedures, four control algorithms and switching algorithms are used to control successively: force, position, force-velocity or force-position. These control algorithms are important to produce the movement of the head, the mother's natural contractions and the mother's pushing action. Different childbirth cases are simulated using an electropneumatic system. The validity of the proposed control method for simulating childbirth modes has been evaluated by an expert obstetrician

This paper deals with a new mechanical birth simulator (BirthSIM). Currently available birth simulators provide manikins that include new-born head and maternal pelvis but they do not produce the movements of the new-born in the mother's pelvis. Furthermore available maternal pelvis do not include interface pressure and are not enough realistic to simulate maternal pelvic muscles. In summary, these simulators do not help students to practice the gestures they should safely use to help the new-born in normal and at-risk situations of delivery. The originality of our mechanical birth simulator, is to provide a system to mimic the last step of the instrumental delivery, to insure a safe training of junior obstetricians and to test new techniques in obstetrics practice. The new mechanical birth simulator is composed of three parts: a physical new-born head and a maternal pelvis manikin, an interface pressure system, and a pneumatic actuator that develops an active resistance. Driven by a computer, the simulator can simulate the contractions, the interface pressure applied in the new-born head and mimic birth complications.