Is it possible to revive a vaginal breech service in your hospital? How have others done this? Is it possible for both obstetricians and midwives to embrace upright breech birth? Dr Kamilla Gerhard Nielsen and Dr Caroline Daelemans will tell you how they have done this in Denmark and Belgium, and how they are changing the way breech births are managed throughout Europe.

This RCM-approved study day for clinical skills trainers, obstetricians, midwives, and paramedics will provide an engaging and interactive update on professional skills to facilitate physiological breech births, planned or unexpected, and how to teach these skills to others. The focus is on collaborative, multi-professional working to improve the safety of vaginal breech birth using the skills of all maternity care professionals. (Note: A small number of student midwife tickets will be released two weeks before the event if places are still available.)

Training will include:

* A research update, including vaginal breech birth and external cephalic version (ECV)

* Examples of successful, collaborative, multi-professional implementation of physiological breech birth clinics/services, with implementation pathways

* Thorough theoretical and hands-on explanations of how breech babies journey through the maternal pelvis in a completely spontaneous birth (the breech mechanisms), enabling you to distinguish between normal progress and dystocia

* Hands-on simulation of complicated breech births and resolutions, using narratives and videos of real breech complications, to enable you to practice problem-solving in real time

* One year's access to video resources following the training

Registration begins at 09:00 for a prompt 09:15 start. Please bring your own lunch.  No refunds can be issued within 1 month of the event, but you are welcome to send someone else in your place.

Feedback from study days in Christchurch & Aukland, October 2016:

My main concern was lack of training of staff leading them to believe that breech birth is an emergency. Our RMOs and MWs loved the day and I think feel more empowered. -- SMO (Consultant Obstetrician, Senior Medical Officer)

Thank you so much, this has been the best study day ever! -- Midwife

Information was clear and concise and well presented. Myths dispelled and physiological VBB and when to intervene very clearly explained. Methods to resolve when there are issues during delivery explained and demonstrated. Clear examples given with supporting video and photographs. Extremely valuable. -- RMO (Registered Medical Officer)

Honest, real explanations. How to intervene in a timely manner as opposed to be hands off the breech. -- Midwife

Thank you for a brilliant day of teaching and training. You covered a lot of material not taught as part of our training and it has been valuable. -- RMO

Learning about manoeuvres to use in upright position, e.g. shoulder press; visual components have been amazing, the broken down physiology of a breech birth. -- Midwife

Facilitators:

Dr Kamilla Gerhard Nielsen, Consultant Obstetrician

Kamilla is a consultant obstetrician from Aabenraa, Denmark. Her unit has the lowest caesarean section rate in Denmark. Part of their success with physiological birth involves fully supporting and implementing upright breech birth with excellent outcomes. Gerhard Nielsen also organised the first Denmark Breech Conference in 2018 and the upcoming conference in 2019.

Dr Caroline Daelemans, Consultant Obstetrician

Caroline is the Lead Obstetrician at Hōpital Erasme in Brussels, Belgium. Erasme began their Breech Clinic implementation process in 2015, and the service has grown with considerable success, increasing the vaginal breech birth rate while maintaining the same good neonatal outcomes.

Dr Shawn Walker, Midwifery Lecturer

Shawn is a UK midwife who researches how professionals learn skills to safely facilitate breech births. She led the development of a breech clinic pathway at the James Paget University Hospital (2012-2014), where she worked as a Breech Specialist Midwife. Her research focus on breech birth is part of a wider interest in complex normality - working with obstetric colleagues to enable women at moderate and high risk to birth and bond physiologically where possible. She currently works as a Lecturer at Kings College London, in addition to periodic teaching, consultancy and breech support across the UK and internationally.

References

Walker S, Parker P, Scamell M (2017) Expertise in physiological breech birth: A mixed methods study. Birth 45(2):202-209.

Walker S, Scamell M, Parker P (2017) Deliberate acquisition of competence in physiological breech birth: A grounded theory study. Women & Birth 31(3):e170-e177.

Walker S, Breslin E, Scamell M, Parker P (2017) Effectiveness of vaginal breech birth training strategies: an integrative review of the literature. Birth. 44(2):101-9.

Walker S, Reading C, Silverwood-Cope O, Cochrane V (2017) Physiological breech birth: Evaluation of a training programme for birth professionals. The Practising Midwife. 20(2): 25-8.

Louwen F, Daviss B-A, Johnson KC, Reitter A, 2016. Does breech delivery in an upright position instead of on the back improve outcomes and avoid cesareans? Int. J. Gynecol. & Obstet. doi:10.1002/IJGO.12033

Reitter A, Daviss B-A, Bisits A, Schollenberger A, Vogl T, Herrmann E, Louwen F, Zangos S, 2014. Does pregnancy and/or shifting positions create more room in a woman’s pelvis? Am. J. Obstet. Gynecol. 211, 662.e1-662.e9.

Walker S, Scamell M, Parker P, 2016. Standards for maternity care professionals attending planned upright breech births: A Delphi study. Midwifery 34, 7–14.

Walker S, Scamell M, Parker P, 2016. Principles of physiological breech birth practice: a Delphi study. Midwifery 43, 1-6.

Walker S, Cochrane V (2015) Unexpected breech: what can midwives do? The Practising Midwife, 18(10): 26-29