About the study

OptiBreech, Stage 1 Summary:

Why? Most babies are born head-first, but about 1 in 25 are bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice.

What? In this study, we are exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. OptiBreech care includes specialist leadership, evidence-based training, and an active birth approach if a vaginal birth is planned.

We do not know whether the OptiBreech care pathway will be safer and/or as cost-effective as standard care. One way to find out is by comparing outcomes within each pathway in a clinical trial. Some important questions must be answered first to design a successful large-scale trial. This is called a ‘feasibility study.’

Who? Women with a breech pregnancy after 37 weeks who choose to plan a vaginal breech birth within their current Trust guidelines will be eligible to participate. They will be offered care from an experienced team with enhanced training.

How? We will follow the outcomes of women and babies. We will also interview them and the staff who care for them about their experiences. We will use routine data, interviews and surveys to determine:

• Are Trusts able to implement the OptiBreech care pathway?
• How much time does it take to develop a proficient team to deliver the service?
• How do women and staff feel about OptiBreech care?
• What adjustments might need to be made to the OptiBreech care pathway to make it feasible to deliver within the NHS?

Where? At least 12 sites from across the UK will participate. The observational study will last for 2.5 years.