Category Archives: Videos

Breech birth videos

There is a small revolution happening around vaginal breech birth, and this is due in large part to the miracles of modern technology, especially videos. Watching many breech births via video enables midwives and obstetricians to develop pattern recognition — what is normal, what is not, when it is time to intervene — without having to attend many breech births. And it enables this to happen more quickly than it would normally happen, over decades of practice. Birth videos also enable us to study the features of breech births in a systematic way in research.

Birth videos will never entirely replace clinical practice, but they can accelerate the learning process. We are incredibly grateful to the women who are enabling this to happen. This blog is addressed to health care providers who may want to ask for permission to film births to support skill development throughout their clinical team.

Permission and the Law

The content of medical care is confidential to the patient, not the health care provider. This means that women have a right to film their births, which are part of their private lives, if they want to. It is, however, respectful to ask for permission.

The GMC provides guidance on the recording of patients, and the principles of informed consent apply. Your employing Trust will also have guidance and forms that can be used to obtain consent, which are usually available from the Medical Illustration Department or similar. You should speak with your managers and team as well. In the Breech Birth Network, we use our own consent form, which you are welcome to use. It allows people to choose from different levels of consent, e.g. just for teaching in person, on-line teaching with restricted access, unrestricted on-line access. It is best practice to take the final consent after filming so that she can identify anything she would like edited out, e.g. if her name is audible or her face is visible., or change her mind.

A copy of any videos should be given to the woman and placed in the woman’s hospital notes.

Access the BBN film agreement here.

Equipment

You will need a good quality video camera. Most phones contain a decent video camera these days, and most of our videos were taken on phones. But something like a GoPro is designed to adjust with movement. GoPros also take in a wider angle than standard phones.

GoPro Chesty

You will need something to hold the camera and ideally, be able to move to get a good angle — so not a static mount. In some videos, it seems as though people are staying ‘out of the way’ in order to enable the camera to get a good shot. This is not a good idea; you want the primary attendant fully focused on the birth and disregarding the camera. In the Hospital of Southern Denmark, filming is the job of the Junior Doctor, who is learning about breech births but not yet managing them.

POV necklace mount

The other alternative is a POV (point-of-view) mount. GoPro make a special chest mount, but … let’s just say they are not designed for women. It’s called a ‘Chesty,’ and that’s exactly how I felt while wearing one. I prefer something called a necklace mount, which keeps the camera closer to where your eyes naturally are and is much more comfortable to wear (IMHO).

I hope this is helpful!

Shawn

June 2020 — online breech learning opportunities

We have a number of online and upcoming learning opportunities available for you.

The Practising Midwife, June 2020

No more hands off the breech” is published in this month’s The Practising Midwife. In this article, I argue that we need to reconsider the way we use Mary Cronk’s famous phrase, “Hands off the breech!,” along with some other commonly held beliefs that may not be helpful.

I’d love to hear what you think about this and how it relates to your experience.

Consultant Midwife Emma Spillane and I are also speaking at the Northern Maternity and Midwifery Online Festival on Tuesday 23 June. I will be talking about improving the safety of breech birth through research, and Emma will be speaking about implementing a breech birth service.

Finally, our Vimeo channel features a couple new videos created to help student midwives learn about research, through the lens of improving breech safety. I’ve posted them below. The settings enable you to share and embed if you would like.

The first video explains one of the studies published as part of this Trio of Breech Articles, an open-access special issue from the journal Birth: Issues in Perinatal Care.

Shawn

International Day of the Midwife 2020

Happy International Day of the Midwife!

Image from Dr Anke Reitter, 2020

This year we honour midwives who continue to do the best job in the world under the most difficult of circumstances. Please enjoy this virtual International Day of the Midwife 2020 celebration from King’s College London student midwives, staff, alumni and collaborators. I’m so proud to be a part of this team!

And as always, we at Breech Birth Network honour the highly skilled midwives around the world who are working to make vaginal breech births safer and more accessible, for the women who choose them and for those who do not have a choice.

As part of the celebrations, I’ve made this video to explain the recent research that Dr Anke Reitter, Alex Halliday and I have done about what ‘normal for breech’ looks like. The video can be shared. Thank you to the women and professionals who have shared their intimate and vulnerable moments to make this possible.

The research is published open-access (FREE!) as part of a trio of breech articles by the journal Birth: Issues in Perinatal Care.

— Shawn

Video analysis and Algorithm paper published!

Practical insight into upright breech birth from birth videos: a structured analysis” is now available on-line! (Reitter, Halliday and Walker, 2020, Birth – https://doi.org/10.1111/birt.12480) This paper represents a few years of hard work by Anke Reitter, me and our Research Assistant, Alexandra Halliday. It contains insights into birth timings and the mechanisms as observed in upright breech birth videos. The Physiological Breech Birth Algorithm is also included.

Download Algorithm

We look forward to much debate and discussion! Please share with anyone concerned about safe vaginal breech birth.

Love,

Shawn

Traduit par: Isabelle Brabant et Caroline Daelmans

India and the breech

Missed our Facebook Live event with Fernandez Hospitals? Watch the recording here:

PMET student Arunarao Pusala receives her training certificate in Karimnagar

This month I am in Hyderabad, India, visiting Dr Evita Fernandez and UK Consultant Midwives Indie Kaur and Kate Stringer. Today at 5pm IST (that’s 11.30 GMT), we will be having a Facebook Live discussion on Breech Birth in India. This will be followed by hands-on workshops on the 12th and 19th in Hyderabad.

with Senior Midwives Theresa and Jyoti

The Fernandez Hospitals are at the forefront of compassionate maternity care on a large scale in India. The Stork Home facility has been beautifully designed and rivals some of the best midwifery units in the UK. But Dr Evita and her team of doctors and midwives are very ambitious. They want to revive vaginal breech skills so that women can confidently choose this option. How will this work in Hyderabad? Join us for a discussion.

Midwives and doulas support women together in the beautiful Stork Home facility in Hyderabad

From Arunarao: “My special thanks to dr Evita ,lndie mam Kate mam and Shawn mam for the opportunity to participate in BREECH BIRTH WORKSHOP at karimnagar.i am so panic about breech presentation and breech birth before I come to professional midwifery training, know iam very excited to assist the spontaneous and assisted breech birth,because now I came to know breech also has its own mechanism and always always we have to respect those mechanism and iam aware of the manoeuvres to apply whenever it’s needed.thank you all of you mam iam so blessed to have a teaching faculty like you.” Thank you Arunarao — you really got it!

Shawn

The Birth of Leliana

Jessica with Leliana

Image: Jacqueline Sequoia, used with permission

From Atlanta, back to Asheville

Jessica’s baby remained persistently breech at term, and she was unable to find a provider in South Carolina to facilitate a vaginal breech birth. When she attempted to decline a CS and negotiate a vaginal birth, she was informed that if she came into the hospital in labour, she would be given general anaesthesia and her CS would be ‘a lot rougher.’ (Folks, the ACOG published something just for you: Committee Opinion No. 664: Refusal of Medically Recommended Treatment During Pregnancy.)

This was Jessica’s first baby, in a frank breech position (extended legs), with no additional complexities. Her sister, Family Practice Doctor Jacqueline Sequoia MD, heard about Dr David Hayes and Harvest Moon Women’s Health because they were hosting my physiological breech birth training. Jacqueline includes obstetrics as part of her practice and booked to attend the workshop with some colleagues. Jessica and her husband Brian met with Dr Hayes to consider their options, and once Jessica made her decision, found a rental apartment in Asheville on Craigslist.

Let’s contemplate that for a moment. In order to have support for a physiological birth, rather than the threat of a coerced CS, women are having to relocate to another state and rent temporary accommodation, because the baby is presenting breech.

When Dr Hayes and I arrived at Jessica and Brian’s apartment, Jessica’s labour appeared to be progressing well. As people entered her space, Jessica gradually moved into the tiny bathroom at the back of the apartment, reminding me of Tricia Anderson’s metaphor of cats in labour. I turned off the light. This labour had a journey, as all labours have. Throughout her journey, Jessica was surrounded by people who love her. At the end of it, Jessica beautifully and instinctively birthed her little girl, Leliana, who weighed 7lbs 8oz.

This video contains graphic images of a vaginal breech birth.

Being attuned to the general lack of training in physiological breech birth among health professionals, and the consequences for women and babies, Jessica and Brian were keen to share this video of Leliana’s birth to help others learn. If you would like to read more about the minimally invasive manoeuvres used at the end of this birth, you can read our blog on Shoulder Press and Gluteal Lift.

brian

Thank you, Jessica, Brian, Leliana, Dr Sequoia and Dr Hayes for sharing this video. The link to this blog post can be shared, but the video cannot be downloaded or reproduced without permission.

Shawn

https://twitter.com/jsequoia/status/736602696115879936

The mechanisms, simplified

January 2015 – See below for videos explaining the mechanisms of breech birth in different maternal positionsdemonstrating

Yesterday, I was in snowy Salford – up north! Senior Lecturer and LME Elaine Uppal invited me with two goals: 1) to make sure her students thoroughly understood the mechanisms of breech birth in preparation for their vivas next week, and 2) to raise money for student electives abroad, particularly in Cambodia, where Elaine has a long-standing relationship with a midwifery twinning project.

After the study day, the students and I made two basic videos to assist their revision.

 

Good luck with your exams, student midwives!

Shawn

Taking a break .. not quite at the edge of the bed.

Taking a break .. not quite at the edge enough to hang & flex!

Jude Jones and Stacey Lee actively understanding women’s birthing positions

Videos: Essential Birth Prep

videosOver and over again, in my research and in personal conversations, I hear how important videos are to health professionals who are self-educating themselves about breech birth. I am still exploring the role of video as a learning tool, but they seem to assist professionals to develop pattern recognition abilities, and enable discussions about clinical decision-making. By watching and talking through what happens in birth videos, these skills can be practiced before they are required in a real-life context.

Here is a list of publicly available on-line videos for health professionals to watch when preparing to attend a breech birth, or to periodically update. Some of them may be close to your idea of ‘ideal,’ and some of them may present a different perspective, or an opportunity for discussion. All of them offer learning opportunity.

Suggested activities:

  • Identify key movements and rotations in the mechanism of breech birth
  • Consider and discuss what prompted intervention, if the video includes intervention
  • What would you do?

You can link to the original posting of the YouTube videos by clicking “View on YouTube” in the bottom right hand corner of the viewer.

Nascimento Mariana – with Dr Priscila Ribeiro Huguet

Frank Breech Home Birth – Spinning Babies Blog, with Gail Tully

The Breech Home Birth of Annaka Faith

Thank you to the very brave and generous mothers, fathers, midwives and doctors who have shared these videos so that others can learn about breech birth.

If you have posted a video of your breech birth, and would like to share that with others, please do include a link in the comments below.

– Shawn