Women’s experiences of planning a vaginal breech birth in Australia

Abstract

BackgroundIn many countries, planned vaginal breech birth (VBB) is a rare event. After the Term Breech Trial in 2000, VBB reduced and caesarean section for breech presentation increased. Despite this, women still request VBB. The objective of this study was to explore the experiences and decision-making processes of women who had sought a VBB.MethodsA qualitative study using descriptive exploratory design was undertaken. Twenty-two (n = 22) women who planned a VBB, regardless of eventual mode of birth were recruited. The women had given birth at one of two maternity hospitals in Australia that supported VBB. In-depth, semi-structured interviews using an interview guide were conducted. Interviews were analysed thematically.ResultsTwenty two women were interviewed; three quarters were primiparous (n = 16; 73%). Nine (41%) were already attending a hospital that supported VBB with the remaining women moving hospitals. All women actively sought a vaginal breech birth because the baby remained breech after an external cephalic version – 12 had a vaginal birth (55%) and 10 (45%) a caesarean section after labour commenced. There were four main themes: Reacting to a loss of choice and control, Wanting information that was trustworthy, Fighting the system and seeking support for VBB and The importance of ‘having a go’ at VBB.ConclusionsWomen seeking a VBB value clear, consistent and relevant information in deciding about mode of birth. Women desire autonomy to choose vaginal breech birth and to be supported in their choice with high quality care.

Complications of external cephalic version: a retrospective analysis of 1121 patients at a tertiary hospital in Sydney

“…19 Information provided should include an accurate portrayal of the risks and benefits of the different options -ECV, elective caesarean section and vaginal breech delivery. It is imperative that women have access to accurate information in a supportive environment to enable them to make informed decisions about their management.…”

“…Women frequently have a strong desire for objective information relating to their individual situation. 19 Information provided should include an accurate portrayal of the risks and benefits of the different options -ECV, elective caesarean section and vaginal breech delivery. Regarding ECV, counselling should include the provision of information relating to minor complications, reversion to breech presentation and an acknowledgement of the rare but serious complications including fetal death.…”

Media Representations of Breech Birth: A Prospective Analysis of Web‐Based News Reports

“…The treatment of this option for birth in the data collected provides an example of how media reporting may demonstrate a bias toward cesarean birth for breech presentation, and this may have an impact on women's decision making for breech birth. The role of clinicians is crucial in providing balanced and nonjudgmental information that is essential for women to support informed decisions about their options for birth when diagnosed with a breech fetus . This may be challenging in the current climate where cesarean birth is seen by many maternity facilities across the world as the safer, default option for birth of a breech fetus.…”

Supporting Women Planning a Vaginal Breech Birth: An International Survey

“…Despite the limited support for vaginal breech birth in maternity facilities, some women continue to request it as an option [15]. Women who plan a vaginal breech birth are often highly motivated and value autonomy in their decision making for birth.…”

“…Women who plan a vaginal breech birth are often highly motivated and value autonomy in their decision making for birth. Previous studies have indicated that these women undertake their own research and choose to navigate the health system to find a clinician who is willing to assist them to give birth vaginally [11,15,16].…”