This baby is not for turning: Women’s experiences of attempted external cephalic version

Abstract

BackgroundExisting studies regarding women’s experiences surrounding an External Cephalic Version (ECV) report on women who have a persistent breech post ECV and give birth by caesarean section, or on women who had successful ECVs and plan for a vaginal birth. There is a paucity of understanding about the experience of women who attempt an ECV then plan a vaginal breech birth when their baby remains breech. The aim of this study was to examine women’s experience of an ECV which resulted in a persistent breech presentation.MethodsA qualitative descriptive exploratory design was undertaken. In-depth semi-structured interviews were conducted and analysed thematically.ResultsTwenty two (n = 22) women who attempted an ECV and subsequently planned a vaginal breech birth participated. Twelve women had a vaginal breech birth (55 %) and 10 (45 %) gave birth by caesarean section. In relation to the ECV, there were five main themes identified: ‘seeking an alternative’, ‘needing information’, ‘recounting the ECV experience’, ‘reacting to the unsuccessful ECV’ and, ‘reflecting on the value of an ECV’.ConclusionsECV should form part of a range of options provided to women, rather than a default procedure for management of the term breech. For motivated women who fit the safe criteria for vaginal breech birth, not being subjected to a painful experience (ECV) may be optimal. Women should be supported to access services that support vaginal breech birth if this is their choice, and continuity of care should be standard practice.

Patient Experiences With Obstetric Counseling on Fetal Malpresentation

“…This study examined the experiences of pregnant individuals as they navigated the process of deciding how to manage fetal malpresentation. Our findings arise in the background of international research on malpresentation management counseling [10][11][12][13][14] and reflect similar themes of patients' preference for comprehensive safety data and detailed information about procedures and surgeries in order to make informed decisions. We found patients diagnosed with malpresentation desire expanded ECV counseling to facilitate their decision to pursue ECV versus CS.…”

What if something goes wrong? A grounded theory study of parents’ decision-making processes around mode of breech birth at term gestation

“…Its findings support planned VBB within certain clinical parameters. Recent literature has also addressed the previous paucity in qualitative research surrounding term breech birth, with studies considering the experiences of both women and care providers (Walker et al, 2018a(Walker et al, , 2018bCatling et al, 2016aCatling et al, , 2016bPetrovska et al, 2016Petrovska et al, , 2017aPetrovska et al, , 2017bSloman et al, 2016;Watts et al, 2016;Homer et al, 2015;Rosman et al, 2014;Say et al, 2013;Menakaya and Trivedi, 2013;Founds, 2007). However, no research has explored the wider influences involved in parents' decision-making around breech birth.…”

What are women’s experiences of seeking to plan a vaginal breech birth? A systematic review and qualitative meta-synthesis

“…After overcoming these challenges, women often encountered additional institutional barriers, such as policies preventing experienced providers from caring for them, at all or outside of regularly scheduled working hours. Although balanced information made a significant difference to women’s decision-making 7 , 29 , many women encountered systemic barriers to accessing balanced, evidence-based information 21 .…”