PPI Meeting, Sunday 30 October, 10 am

We would like to hear from you! 

Link to join (Teams)

We are in the process of developing a research proposal for a feasibility study to investigate the implementation of bedside resuscitation for breech babies who require breathing assistance at birth.

Research indicates that providing this immediate care next to mothers/birthing people reduces parental distress and is found to be more favourable by clinicians due to improving communication with parents while they provide care.

The purpose of this group session is to gain insight and feedback regarding our research aims and design from stakeholders to ensure the research is the next piece of the puzzle in improving breech care, designed appropriately, and acceptable to women/birthing people.

We have scheduled this meeting for 90mins to ensure everyone has enough time to discuss the proposal and ask any questions and we will also provide an optional short survey for anyone to provide any additional feedback if they were not able to during the meeting.

The meeting will be held on Sunday 30th October 10am – 11.30am via Microsoft Teams. You can attend the meeting for the full 90mins or attend like a drop in session. 

We look forward to meeting with you and hearing your thoughts.

Link to join

With very best wishes,

The OptiBreech Team

Plain English summary of the research (limit 400 words):

OptiBreech Care is a specialist care pathway for women whose baby is positioned bottom-down (breech) at the end of pregnancy. Our team previously studied how hospitals provide team care when a woman requests a vaginal breech birth to make sure it was possible. In this model, women found it easier to plan their choice of a vaginal breech birth or a pre-labour caesarean birth. Fewer women had emergency caesarean births, and outcomes for babies were at least as good as standard care. OptiBreech teams found one aspect difficult: leaving the umbilical cord attached if the baby needs help to start breathing. Team members told us this is challenging to achieve because they do not have appropriate equipment and training.

About 1:5 babies born after a vaginal breech birth need some help to start breathing, and about 1:10 are transferred to a neonatal intensive care unit after the birth. We feel we can reduce this to 1:5 (the UK national average for all births) if our specialist teams are able to provide help next to the mother. This will result in better long-term outcomes for the baby. Families have better experiences if they are not separated from babies, during resuscitation or after. Women in our OptiBreech studies have reported feeling let down because in most births where the baby appeared to need help, the cord was cut immediately, despite OptiBreech and UK Resuscitation Council guidance.

We aim to learn how to get optimal cord management right for every birth, how much it will cost and how it may improve outcomes for babies if we do this. We will supply one site with bedside trolleys and team training; another site will use trolleys they already have, with additional support; all thirteen remaining sites will continue to try to implement the recommendations with what they already have. We will observe the process for 12 months initially, during which we would expect 205 planned breech births to occur. We will conduct interviews with staff, parents and birth supporters following births where babies have needed support, to understand how this is working, or not.

By studying the process within small teams, who care for a population at higher risk of needing assistance to begin breathing at birth, we will be able to study and share insights that can improve the process for all teams, across the UK population of term births. We will share our results in scientific papers and a toolkit. Our research team includes a service user who has planned an OptiBreech birth, who will help us to involve other service users in shaping the research and to communicate the results of the research to a wide audience.

BICS2022 Conference

The OptiBreech Research and Public Involvement team share their work at the #BICS22 conference.

The OptiBreech Team enjoyed meeting each other in person for the first time at last week’s British Intrapartum Care Society Conference. And we won a prize! We are so grateful to the women who have participated in our research, the Principal Investigators who have made it all happen locally, and our Steering Committee. Here’s what we shared at the conference:

Dr Siddesh Shetty and Dr Shawn Walker

Is it feasible to test OptiBreech Care in a clinical trial?: results of the OptiBreech 1 study – Dr Shawn Walker, Tisha Dasgupta, Siân Davies, Sarah Hunter, Phoebe Roberts, Prof Jane Sandall, Prof Andrew Shennan. We shared the results from our first-stage study, OptiBreech 1. We are currently writing these up in publication format and will share as soon as that is ready. This presentation won the top oral abstract prize at the conference.

The roles and responsibilities of breech specialist midwives in the OptiBreech Care Trial feasibility study: a qualitative inventory Davies, Dasgupta, Natasha Bale, Alexandra Birch, Walker. Siân Davies shared a poster about the role of Breech Specialist Midwives, as described by midwives and obstetricians participating in OptiBreech 1.

Toolkit for implementing breech clinics and specialist midwives to support planned vaginal breech births – OptiBreech PPI Lead and Service User Representative Phoebe Roberts presented this poster. Read more about it here.

Ritika Roy and Cecelia Gray

Women seek ‘connected autonomy’ when they wish to plan a vaginal breech birth at term: a systematic review and meta-synthesis – Ritika Roy, Cecelia Gray, Charlene Prempeh, Walker. Medical students Roy and Gray presented the results of their 2021 King’s Undergraduate Research Fellowships. The results are ready for publication and will be shared in that format soon!

Not too fast not too slow: the legacy of time management in vaginal breech births Jacana Bresson, Walker. Midwifery student Bresson presented the results of her review of obstetric texts in the Royal College of Obstetricians and Gynaecologists and Wellcome Trust Libraries, funded by a 2022 King’s Undergraduate Research Fellowship.

Assessing feasibility of economic evaluation alongside a full trial for ‘OptiBreech Care’ with development and testing of a decision model to assess its long-term cost-effectiveness Dr Siddesh Shetty, Dr Shawn Walker, Prof Julia Fox-Rushby. The Health Economics team used this as an opportunity to gain feedback and peer review on the economic model developed.

Thanks also to the BICS Committee, who organise a wonderful, supportive, multi-disciplinary conference every time!

Specialist midwives and clinics – inviting your views

Help us get it right, Wednesday 19th January 2022, 12:00-13:00. Are we accurately reflecting your views on breech specialist midwives and clinics?

We would like to invite women, birthing people and their families who have experienced a breech pregnancy at term to attend an online focus group discussion on Wednesday 19th January 2022, 12:00-13:00 to be conducted via Microsoft Teams.  Anyone with an interest and experience of breech pregnancy can participate.

The purpose of this meeting will be to get your perspective on the work we have been doing so far.

We have been working on analysing data from qualitative interviews held with OptiBreech 1 participants. To date, we have interviewed 15 women purposefully sampled to reflect various OptiBreech sites, mode of births, and outcomes. Our main objective was to understand what makes the OptiBreech intervention acceptable (or not) to women.

The key themes that we have found are:

  1. Access to skilled breech care: Vaginal breech birth as a viable and safe option is still unknown to many, and lack of specialists reduced equity of access. Women who were referred to a specialist at one of the OptiBreech sites or were already receiving care at a study site found it easy to access and participate in their care. Women who had to transfer care from another hospital or find an OptiBreech site themselves had a difficult time doing so, often requiring increased effort, multiple trips, time off work etc. 
  1. Balanced information: Women really appreciated being provided balanced information on the safety and risks of vaginal breech birth vs. caesarean section including possible complications and how to manage them. This enabled them to make autonomous informed decisions and increased self-efficacy and confidence, not only in themselves but also in the breech specialist midwife. Conversely, when women had to do this research themselves because they were not getting cohesive information from the healthcare professionals, this was seen as a burden and sometimes women were made to feel pressure to choose caesarean section as the ‘safe’ choice. 
  1. Shared responsibility: Women often felt emotional burden including feelings of stress, judgement, and guilt because of the choices they had made to have a vaginal breech birth, both from family and friends, as well as other healthcare professionals. Speaking with and being cared for by the OptiBreech specialist midwife helped ease this emotional burden and gave the women confidence in their choices.
  1. Team dynamics: We found that women had placed an enormous amount of trust and confidence in the breech specialist midwife which extended to the rest of the team, attributed to previous experience, skills and knowledge. Although women did not know all the members of the team, the trust and confidence was extended to them because of shared responsibility and training requirements needed by all OptiBreech team members.

We need your input on our findings and invite your opinions on whether these findings are relevant to you, if we have interpreted them correctly, or if we have missed any important factors in what makes OptiBreech an acceptable intervention. At the meeting we will present a short summary of our findings so far, and then have an open discussion to hear any thoughts, opinions, or questions you may have.

The meeting will be held on Wednesday 19th January 2022, 12:00-13:00 via Microsoft Teams.  

Join on your computer or mobile app  

Click here to join the meeting  

Breech-COS international study launches

Round 1 of the international multi-stakeholder Delphi study, Development of a Core Outcome Set for Effectiveness Studies of Breech Birth at Term (Breech-COS) is now open. We invite the involvement of anyone from the following stakeholder groups, who has experience of care for women having vaginal breech births:

QR code for Breech-COS Round 1
  • obstetrician
  • midwife
  • service users (you or your partner have had a breech-presenting baby within the last 5 years)
  • neonatologist
  • researcher
  • health services manager
  • healthcare commissioner
  • health economist
  • statistician
  • support group representative
  • other relevant roles

You can read more information about the research and participate using the link or the QR code below. You are welcome to share this post or forward to your stakeholder associates.

Participation Link: https://qualtrics.kcl.ac.uk/jfe/form/SV_b4uw2QJxcTC8oZM

This consensus-building activity follows on from our systematic review, including Patient and Public Involvement (PPI) activity, Development of a core outcome set for effectiveness studies of breech birth at term (Breech-COS): A systematic review on variations in outcome reporting.

Shawn Walker, on behalf of the OptiBreech team

We would like to hear from you!

We are in the process of developing the protocol and study materials for Stage 2 of the OptiBreech study which will be a multi-centre prospective observational cohort study designed to support multiple trials of care for women with a breech pregnancy at term. 

In the next phase of our study, we will begin to record outcomes for breech pregnancies and births from several more hospitals across England, Wales and Scotland, on a large database. Personal information, such as names and NHS numbers, will be kept separately from information on the outcomes of pregnancies, so that those who participate are not identified by anyone looking at the data. We will need to collect a lot of data and store it for a long time, so it’s important we get this right. We want to ensure we are providing information about the study in a way that is clear and ethical. 

OptiBreech 2 will involve randomly allocating women to different care pathways, and creating a large scale database of term breech pregnancies for the purposes of 1) establishing safety outcomes in real-world settings and 2) conducting multiple nested trials to establish effectiveness of interventions in the breech care pathway. 

Also, we will be asking some women to allow us to assign them by chance to one treatment or another; this is called ‘randomisation.’ Assigning people by chance enables us to be sure that any differences we see in outcomes are due to the treatment and not something else. For this reason, evidence obtained following random assignment is considered the highest quality evidence. We would like to know how you feel about this and how we are proposing to do it.  

We would like to hear your views on the acceptability of randomisation as well as on the Participant information sheet and Consent forms (linked below).

We’ve created a Participant Information Sheet, with information about the study, and a Consent form, which we would need each participant to sign. We would like to ensure these are clear. And we invite you to tell us if you think we should be doing something differently. 

The meeting will be held on Wednesday 16th June, 11:00–12:00 via Microsoft Teams.  

The link to join: https://teams.microsoft.com/l/meetup-join/19%3ameeting_NjY2YWU3ZGUtYjUwMi00NmQxLWE0ZjMtZGUwMjFlNzRlNmIw%40thread.v2/0?context=%7b%22Tid%22%3a%228370cf14-16f3-4c16-b83c-724071654356%22%2c%22Oid%22%3a%220b7b88cc-f549-43c3-a733-ff811056d022%22%7d

We hope to see you there!

Saturday at 2pm: Consultation on Draft NICE Antenatal Care Guideline — Breech Birth Network

You are invited to an open discussion about the Draft of the new NICE Antenatal Care Guideline. Breech Birth Network would like to collect the views of families who have experienced a breech presentation at term and care providers on the draft guidance. Josephine and Thiago talk about their experience of Ulysse’s breech birth at…

Saturday at 2pm: Consultation on Draft NICE Antenatal Care Guideline — Breech Birth Network

Inviting your views …

We invite participation in an on-line PPI (patient and public involvement) meeting to be held on the 10th of December.

We would like to invite women, birthing people and their families who have experienced a breech pregnancy at term to attend an online focus group discussion on Thursday 10th December 10.30-11.30am to be conducted via Microsoft Teams.  Anyone with an interest and experience of breech pregnancy can participate.

The purpose of this meeting will be to get your perspective on the following issues: 

A core outcome set is a minimum set of outcomes that should be collected in every study about a topic, in this case vaginal breech birth at term. Making these consistent means that we can better compare and combine studies, and ensure research meets the needs of those who use it.

To develop a core outcomes set, we have conducted a systematic review of the available literature relevant to this project (brief summary below). However, we need your input to determine if these outcomes are important to the people who will use the results of research to make decisions, and how important each is. Does this meet all your informational needs or are there outcomes that have not been identified, which you think is important to record? 

Do you think it is important to include salutogenically focused outcomes that emphasize positive well-being of the mother and newborn such as maternal satisfaction, relationship with baby etc.? If so, which factors would you like to see and how important do you think these are? 

The next stage will be to ask both professionals and service users to rate the importance of the outcomes to be included in the core outcome set. But before we do this, we want to insure all of the outcomes important to you are included.

You are welcome to share your feedback directly during the focus group meeting or by emailing Tisha Dasgupta (tisha.dasgupta@kcl.ac.uk), the OptiBreech Research Assistant, at any point. If you are unable to make it and would like to contribute, or have further feedback after the session, please also contact Tisha.

While we do not require written consent for your participation in the meeting, it is important to let you know that the session will be recorded. We intend to take the feedback you provide into consideration while designing the next stage of this project: a multinational Delphi study. No identifiable information will be used such as direct quotes or anecdotes, and we will only report summary data.  

Thank you very much for your consideration. Please could you send your RSVP to tisha.dasgupta@kcl.ac.uk by Monday, 7th December to confirm your attendance at the session? She will be in touch thereafter to provide you access to the online meeting.

More information:

The COMET Database

The CROWN initiative

We’d also love to hear your views on the information presented on the OptiBreech website!


Overall summary of the Systematic Review

A systematic review of all relevant literature was conducted to identify outcomes, definitions and measurements previously reported in effectiveness studies of breech births at term. 108 studies were identified comprising of systematic reviews, randomised controlled trials and comparative observational studies, with full-text available in English. Below are the most common outcome measures, with a percentage of how many studies reported them. These are the top 10 most frequently reported measures in each category grouped by neonatal, maternal, features of labour, and long-term maternal outcomes respectively.

Neonatal outcomes

Outcome measure% studies reported
APGAR score at 5 minutes78.7
Perinatal or neonatal mortality68.5
Admission to neonatal intensive care unit (NICU)59.3
Neonatal birth trauma/morbidity53.7
Brachial plexus injury / peripheral nerve injury38.0
Low umbilical artery pH35.2
Bone fracture33.3
Neonatal seizures/convulsions31.5
Intubation/ventilation29.6
Hematoma (cephalic or subdural)20.4

Maternal outcomes

Maternal mortality24.1
Post-partum haemorrhage (PPH) 16.7
PPH requiring blood transfusion14.8
Other serious maternal morbidity/other complications14.8
Genital tract trauma13.0
Wound infection requiring prolonged hospital stay/re-admission12.0
Deep vein thrombosis (DVT) requiring anticoagulant therapy10.2
Prolonged hospital stay9.3
Hysterectomy8.3
Anaemia7.4

Features of labour

Vaginal Delivery97.2
Emergency Caesarean88.0
Elective caesarean80.6
Induction of labour24.1
Instrumental vaginal delivery18.5
Manoeuvres used17.6
Regional anaesthesia15.7
Trial of labour14.8
Actual mode of birth13.9
Duration of delivery/second stage13.9

Long-term maternal outcomes

Urinary incontinence6.5
Breastfeeding complications5.6
Faecal incontinence5.6
Postnatal depression5.6
CS in subsequent delivery5.6
Long term abdominal pain4.6
Dyspareunia4.6
Flatus incontinence4.6
Relationship with partner4.6
Long term perineal pain3.7

PPI with professionals around the UK

Each time I teach the Breech Birth Network Physiological Breech Birth Study Day, I explain the feasibility study and trial I am hoping to do and invite feedback from those attending. Below are examples of feedback from around the UK:

  • London, May 2019 — St Thomas’ Hospital
  • Ormskirk, Lancashire, August 2019 — Edge Hill University
  • London, October 2019 — St Thomas’ Hospital
  • Hayward’s Heath, December 2019 — Princess Royal Hospital

Some surprising feedback in a recent meeting with the Lead Obstetrician and Director of Midwifery in one of the South London teaching hospitals who are not currently planning to participate in the randomisation element of the feasibility study. This hospital is further along implementing a breech clinic and some on-call element to support physiological breech births. Because of this, they feel it might be unethical to randomise women to ‘standard care,’ as outlined in the Description of Intervention. They will still be participating in the implementation evaluation aspect of the feasibility study. I and the Steering Group will be considering this and feedback from other Trusts when deciding if the final design should be modified in a larger study.

PPI: Influence on design

In addition to face-to-face activities, when developing this proposal I circulated an invitation to participate in PPI via my professional blog (breechbirth.org.uk) and social media. Twenty-one women and three people who work with pregnant women (midwife, doula, osteopath) expressed an interest. Some of these women attended the face-to-face meeting at St Thomas’ Hospital in April 2019, organised by the South London Maternity Voices Partnership. I met with two women individually in East Anglia, and seven women responded to a survey (via SurveyMonkey) asking about their views on the plain English summary of my proposal. This post reports the responses of these seven women to this summary and how this has influenced the form of the final proposal.

All comments are reported and all women were asked for permission to share these responses anonymously.

All seven women (100%) indicated that, “I or my partner have had a breech baby within the last 5 years,” within the UK. Comments included:

I had an undiagnosed breech vaginal delivery in 2015, in spite of having had numerous palpations/sweeps in the weeks leading up to the birth.

I experienced my own undiagnosed breech birth (vaginal delivery) in December 2015. Happy to provide in depth detail of my birth story; it is also published in my own work on this.

My breech baby was undiagnosed as breech, so I have no experience of what it feels like to contemplate the choice between natural breech birth or cesaerean. I am however part of various breech networks on social media and take part in many discussions about this. I had my breech baby at home, and unassisted, with no complications.

“I gave birth at home to my frank breech baby. I wasn’t supported by most of the health professionals I met and when it came to the birth it didn’t feel safe to go to our hospital where they were very short staffed and my labour progressed too quickly for me to get there! I trusted my body knew what to do and our baby was born safely with my just my husband watching! Paramedics arrived and our doula as our baby was born. The midwifes weren’t available for another 4 hours! It was a huge shame as they missed the opportunity to experience my calm, pain free, extremely well researched breech birth.” 

Impact on proposal: ‘Undiagnosed breech birth’ means the breech presentation is diagnosed for the first time when the woman is in active labour, rather than during her antenatal care. Occurrences of undiagnosed breech births seem a significant component of ‘breech experience’ among women in the UK. My original proposal focused solely on management of breech presentations that are diagnosed antenatally, but I realised this is not enough. Also, the last randomised controlled trial of term breech births (Hannah et al 2000) included breech presentations diagnosed for the first time in labour. Although recruitment during labour is particularly challenging, PPI feedback indicates meeting this challenge is important.

These results were similar to those received in the face-to-face and staff PPI activities.

I think women will want to take part to ensure that breech pregnancies and births are better dealt with. Natural births of breech babies should be supported more, so this study will help.

I feel women would participate especially if they have had choice taken away from them. Enabling informed choice and joint decision making is crucial for all woman no matter what presentation.

Yes but only if they are reassured prior to birth that they will not be forced into a certain birthing choice because they signed up for the trial. I think constant reminders would be helpful to them that they still have choice throughout otherwise this could be a potential barrier to recruitment.

I felt very pressured during my pregnancy by doctors, and really struggled to make choices. (Whether to homebirth or not). I feel that any woman in this situation or who has had previous experience of hospital would be very glad to take part in something that could change the way women are treated and spoken to in hospitals. I personally would be willing to take part in any research that improved the way pregnant women are treated.

If the question is meaning the breech births that have already happened then it is likely the women will want to take part to help other women. If it is for women about to give birth to breech babies then it depends on how confident, trusting and educated her team of midwives and consultants are of breech vaginal delivery.

Influence on research design: At least some women find decision-making around mode of childbirth with a breech baby difficult, and that at least some women have felt pressured and have experienced a lack of respectful care. Ensuring this research does not result in harm of this type is important to me. This influenced the design in the direction of a pragmatic RCT. In the original proposal, I had planned to conduct an efficacy study, which requires strict adherence to group allocation. However, through engagement with women I came to feel this would not be ethical, nor would it provide the type of ‘real world’ decision-making information women wanted. Recruitment would also have been more difficult.

It will give women a better understanding of their options and what they consist of. It will help women come to the right decision that best suits them.

Empowering women to trust in their body’s natural ability will always be a positive thing

Yes, any additional information to what is already known will always serve to be helpful to women and allow them to make more informed choices.

I think there is very little information available on breech birth, and the stuff that is isn’t “readily” available unless you go looking for it and do your own research. I think newer studies and studies with more data are definitely needed and would provide women with up to date research and the information they need to make informed decisions. 

Any extra research would definitely be helpful, the way the world is now it seems most people like statistics and there’s so much health and safety surrounding breech births in many hospitals/countries. Women are then too nervous by the lack of skill so they opt for a c-section.

This is fantastic! I gave birth to my breech baby in November 2017! It was the most incredible experience of my life where I truly tuned into my body. I did huge amounts of research during pregnancy and continue to do so now. Birth is incredible but breech birth is fascinating and it’s become my passion. I would love to be involved with this as much as possible!

Influence: I have created a mailing list to keep all respondents informed of the progress of this research and aware of any opportunities to contribute further, with clear information about how to remove themselves from the list and have any personal data deleted.

Below are some additional comments from women who did not participate in the survey, but expressed interest in PPI participation in general. Although I have anonymised responses, aside from one link the person wanted to share, they came from all over the UK. Women seeking support for a current pregnancy were referred to an independent breech midwife not involved with this research, with their permission.

I just came across this. I’m don’t work in the medical profession but my baby was a breech baby. I requested a vaginal delivery which was very negatively received by my hospital. I very much wanted to attempt it, which I did (in the understanding that if it became too dangerous I would agree to a c-section) However I have found out from a report that the second stage of my delivery was very poorly managed and sadly my baby died just after he was born. I was very much made to feel Like it was my fault for the birth choice I made. I truly wish there had been more open discussion about how my hospital felt about it and why they were so reluctant to support me. Breech birth should be talked about and openly discussed more. Great that it’s finally happening.

I experienced primi breech vaginal birth under Dr X in X Hospital, X city in 2014. I had a doula and I’ve trained to be a doula since. Breech birth in hospital can and should happen, and happen safely. I’m interested in being involved if I can be of use.

During my last pregnancy we found out baby was footling breech at about 36 weeks during a growth scan. Previous to this all midwives and doctors has told me he was head down. I had an ecv and went on to have a successful vaginal birth at 41 +3

I had a breech baby by (reluctant) c-section 3 years ago. There was a general lack of experience in vaginal breech birth in my area.

My daughter (born November 2016) was undiagnosed breech. My waters broke and instead of waiting for the normal 24hrs, the obstetrician recommended an induction as the midwife had picked up a small drop in her heart rate. It was the obstetrician’s opinion that the drop was probably due to position but still no one noticed she was breech. The diagnosis came when I was 5cm dilated and a midwife felt the my daughter’s bum during a VE. I wasn’t given much of an option then and whisked into an emergency c-section.

I’m pregnant again and though still early (28 weeks) baby is currently breech too. I’m trying to explore all my options and to be prepared for different scenarios this time round, but am finding that a lot of the research I come across is inconclusive. If there’s anything I can do to help, I’d be very happy to contribute.

Im currently pregnant with extended breech baby. my second pregnancy. no risks.

I would like to consider the natural birth. Doctors recommend CS but I don’t feel I got all the information to make informed decision.

I heard confusing message like we have no experience which is concerning and no statistics but more list of things which can go wrong.

I would like to find out pros and cons so I can make informed choice.

I would appreciate if you can get in touch with me.

I am 38.5 weeks pregnant.

I’ve stumbled on your website by chance. I had a breech baby in October 2016 at X Hospital. We didn’t discover breech until 41 weeks and at that point I was immediately coerced into agreeing to a c-section which was performed less than 12 hours later. I found the experience highly traumatic and ended up with anxious episodes (flashbacks/obsessive thoughts/nightmares etc etc) which required counselling. 

I would love to be able to help with your research in the hope that future women do not have to experience what I did. 

I’d like to register my interest. I had a breech pregnancy in 2014 which resulted in a Caesarean section. 

I’d love to help in anyway possible. I’m currently a final year Midwifery Student with a passion for VBB and the topic is also my dissertation topic. 

Definitely interested in helping in any way with the research!

I used this site and many others in order to make a decision about my recent birth. My baby was extended breech for most of the pregnancy and after reading as much as I possibly could about why a possible vaginal delivery was possible I declined the elective section and waited for natural labour to happen.

Supported by my NHS midwives, I went into labour and made the plan to labour naturally in hospital for a set amount of time and opt for no intervention and an emergency c if things didn’t progress. After an amazing 22 hour labour, a few hours fully dilated with faint declining contractions and no desire to push and no descending baby, I opted for (a calm and requested by myself) “emergency” c and was so happy to have been given the opportunity to give natural birth a good go, and know when to call it a day and not force it.

My full story is here:

http://breechbabiesclub.org/rebecca-and-jax-breech-birth-letting-go-and-taking-control/

I wanted to share my story but am really happy to be involved in any research. I was only able to make a decision about my birth as I asked CONSTANT questions and read every single possible thing I could about breech birth. More information definitely needed so women can also make this decision for themselves and like me, EVEN thought I had an emergency c, come out the other end ELATED with their experience as they know they made all the right decisions based on information and not scare stories or sweeping statements.

Thanks for listening 🙂

I am currently 40 weeks pregnant with a breech baby hoping for a natural delivery and I would like to be involved in this project.

I had a very happy breech birth experience in February this year at X Hospital in Wales, X. I was due to have a c-section but went into labour early and then opted for vaginal birth, with encouragement from team of medical staff. Incredible midwives guided me through whole process. I feel so pleased and privileged to have such a positive birth story.

I had an undiagnosed breech vaginal birth 15th March 2015. My daughter had no complications and neither did I. She was born at 40+1. I would be happy to take part in any studies that I may be able to help with.

I saw on the X Facebook page that you are conducting studies on Breech babies.

Unfortunately I’m not available on 29th April but would be happy to help in any other way I can.

My daughter now 13months was a breech baby and I desperately wanted a vaginal birth so had to ECVs to try and turn her. They were both unsuccessful. I refused a planned c-section hoping to deliver vaginally but after 18hours of labour which didn’t progress very well I eventually had a c-section out of fear of endangering her life.

I wish there had been more support to enable a vaginal delivery. I felt that most staff didn’t feel confident enough to support and allow a breech vaginal delivery.

Proposal Development: What do staff think?

In developing this proposal, I sought feedback from clinical leaders in the participating Trusts, as well as my research support team and personal international network of breech clinicians.

In May 2019, a Physiological Breech Birth study day was held at St Thomas’ Hospital in London. This included presentation of the feasibility study design, with an invitation to provide feedback via the Poll Everywhere app.

A total of 77 people attended the day. Information on their backgrounds is below.

All attendees received a Description of Intervention and an explanation of the feasibility study design by the Chief Investigator. We asked health care professionals and trainees how many women they felt would be willing to participants. Their responses ranged from 0-8, with a mean of 4.3. This was slightly lower than predicted by PPI work with women.


Reassuringly, after learning about physiological breech birth and the proposed feasibility study, professional opinions about the potential of the intervention appeared largely positive. But this was a self-selecting audience who chose to attend the study day and may not reflect the opinions of the wider maternity care team. And not everyone who attended the day was able to stay until the end to complete the survey.

Physiological Breech Birth care depends on a portion of health care professionals being willing to work flexibly in order to ensure experienced support at breech births. Feedback indicated that, although this was not something every practitioner was willing to do, a sufficient number to create a breech team was likely to be achievable.

Read more about health care professionals’ responses to the feasibility study design:

Written by Shawn Walker, 6 June 2019