Comparison 1. Simulation‐based obstetric team training (SBOTT) versus no training.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Maternal mortality	2	79246	Risk Ratio (IV, Fixed, 95% CI)	0.82 [0.30, 2.27]
1.2 Perinatal mortality	1	28657	Risk Ratio (IV, Fixed, 95% CI)	0.75 [0.53, 1.07]
1.3 Neonatal mortality	2	79246	Risk Ratio (IV, Fixed, 95% CI)	0.70 [0.48, 1.01]
1.4 Composite outcome of maternal and perinatal morbidity	1	28657	Risk Ratio (IV, Fixed, 95% CI)	1.00 [0.78, 1.27]
1.5 Composite outcome of maternal complications	1	50589	Risk Ratio (IV, Fixed, 95% CI)	0.82 [0.41, 1.62]
1.6 Weighted Adverse Outcome Score	1		Other data	No numeric data
1.7 Eclampsia	2	79246	Risk Ratio (IV, Fixed, 95% CI)	0.64 [0.31, 1.31]
1.8 Obstetric hemorrhage	1	50589	Risk Ratio (IV, Fixed, 95% CI)	0.72 [0.32, 1.63]
1.9 Hysterectomies	2	79246	Risk Ratio (IV, Fixed, 95% CI)	1.33 [0.64, 2.75]
1.10 Cesarean delivery	1	50589	Risk Ratio (IV, Fixed, 95% CI)	0.79 [0.67, 0.93]
1.11 Low Apgar score (<7 after 5 min)	2	115171	Risk Ratio (IV, Fixed, 95% CI)	0.99 [0.85, 1.15]
1.12 Hypoxic ischemic encephalopathy	1	28657	Risk Ratio (IV, Fixed, 95% CI)	3.20 [0.78, 13.15]
1.13 Trauma due to shoulder dystocia	1	28657	Risk Ratio (IV, Fixed, 95% CI)	0.50 [0.25, 1.00]
1.14 Team performance in practice (skills / procedures)	2		Risk Ratio (IV, Fixed, 95% CI)	Subtotals only
1.14.1 Use of prespecified obstetric procedures	1	48	Risk Ratio (IV, Fixed, 95% CI)	1.90 [1.13, 3.18]
1.14.2 Pro‐active treatment of post partum hemorrhage	1	28657	Risk Ratio (IV, Fixed, 95% CI)	2.20 [1.22, 3.97]
1.15 Team performance of the obstetric care team (follow‐up: 8 months)	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
1.15.1 Overall team performance	1	48	Mean Difference (IV, Fixed, 95% CI)	1.00 [‐0.02, 2.02]
1.15.2 Communication	1	48	Mean Difference (IV, Fixed, 95% CI)	1.60 [0.49, 2.71]
1.15.3 Situational Awareness	1	48	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐0.34, 1.94]
1.15.4 Decision Making	1	48	Mean Difference (IV, Fixed, 95% CI)	1.10 [0.02, 2.18]
1.15.5 Roll Responsibility	1	48	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐0.47, 1.07]
1.16 Evidence‐based birth practices	1		Other data	No numeric data