New publication: Women’s experiences

New publication: Women’s experiences of seeking to plan a vaginal breech birth: a systematic review and qualitative meta-synthesis.

The extended OptiBreech team is pleased to announce a new publication.

Ceclia Gray and Ritika Roy (joint first authors) lead a systematic review and qualitative meta-synthesis of women’s experiences of seeking to plan a vaginal breech birth. Gray and Roy are King’s College London medical students who were funded to undertake this work by King’s Undergraduate Research Fellowships.

Women seeking to plan a VBB feel vulnerable and wish to connect with capable and confident healthcare providers. To meet their needs, services should be designed so that they can connect with clinicians who are willing and able to support their autonomy. Services should also seek to limit their exposure to disrespectful and judgemental interactions with healthcare providers.

Gray and Roy were joined by service user co-researcher Charlene Akyiaa Prempeh-Bonsu, who planned a vaginal breech birth in the NHS herself within the past five years. Prempeh-Bonsu contributed to data analysis with support and reflective discussions. She helped to ensure the work reflected the needs and interests of the population being described.

The work was supervised by Dr Shawn Walker.

Roy R, Gray C, Prempeh-Bonsu CA and Walker S. What are women’s experiences of seeking to plan a vaginal breech birth? A systematic review and qualitative meta-synthesis [version 1; peer review: awaiting peer review]. NIHR Open Res 2023, 3:4 (https://doi.org/10.3310/nihropenres.13329.1)

What has your experience been? Have you planned (or tried to plan) a vaginal breech birth within the UK NHS? We invite you to leave a comment below. Please let us know if you gave birth within an OptiBreech site, or not.

International Collaborators

An initial objective of this research is to develop a core outcome set for effectiveness trials of vaginal breech birth (COMET). Establishing a core outcome set enables the results of trials to be combined and compared in meta-analysis and gives us a way to judge the effectiveness of interventions across settings.

If it does not prove feasible to conduct a randomised trial, a different design may work better. For example, a large prospective observational study, using the same core outcome criteria. While many sites within the UK are implementing physiological breech birth, many successful early adopters are outside of the UK. Collaborating with them will enable each of us to demonstrate local results, and to identify the incidence of rarer outcomes such as perinatal morbidity and mortality (death or serious illness around the time of birth).

Therefore I am proceeding with both potential projects in mind, so that the work has a flexible back-up plan for providing the answers that women and health care professionals want about physiological breech birth. I have applied for a smaller grant, which would fund the outcomes consensus project and creation of an on-line database, to which collaborators anywhere in the world could contribute once local approvals are obtained. If both applications are successful, the international prospective observational study would provide evidence of the generalisability of any results we see within the UK study.

International collaborators who have agreed to lead data collection in their countries are:

  • Germany — Dr Anke Reitter, Chief Obstetrician, Krankenhaus Sachsenhausen, Frankfurt
  • Australia — Dr Andrew Bisits, Director of Obstetrics, Royal Hospital for Women, Sydney
  • Denmark — Dr Kamilla Gerhard-Nielsen, Obstetrician, Syghus Sønderjylland, Aabenraa
  • Netherlands — Dr Floortje Vlemmix, Amsterdam Universitair Medische Centra; and Dr Leonie van Rheenan-Flach, OLVG West, Amsterdam
  • Sweden — Dr Julia Savchenko, Obstetrician, Södersjukhuset, Stockholm
  • Canada — Jane Wines, Midwifery Lecturer, University of British Columbia
  • Ethiopia — Kidist Eshetu Berhahu, Hawassa College of Health Science, Ethiopia; and Shimeles Tsegaya Tessema, Dilla University
  • Hungary — Dr Zoltan Kovacs, Obstetrician, Robert Hospital, Budapest
  • Brazil — Professor Melania Amorim, Senior Researcher & Obstetrician, Instituto Paraibano de Pesquisa Professor Joaquim Amorim Neto (IPESQ) and Dr Priscila Ribeiro Huguet, San Paolo
  • Belgium — Dr Caroline Daelemans and Dr Sara Derisbourg, Erasme Hospital, Brussels
  • India — Dr Evita Fernandez and Indie Kaur, Fernandez Hospital Foundation, Hyderabad
  • United States — Dr Emiliano Chavira, St Francis Medical Centre, and Dr Annette Fineberg, Sutter Davis Medical Centre, California, USA
  • Spain — Carmen Medina Mallen, Hospital de Sant Pau, Barcelona

If you are potentially interested in collaborating in this project, please contact me via the form below.