Emma and I frequently receive requests for elective placements from students keen to experience midwifery practice related to breech birth. We wrote this post to provide some guidance into what you can do if you would like to gain more breech exposure.

Elective placements are tricky for a number of reasons:

1. At the moment, COVID-19.
2. A lot of administrative paperwork for a short placement.
3. We need to prioritise students from our local universities.
4. Direct work with women with a breech-presenting baby is only a small part of what we do.
5. No guarantee there would be any breech births during this period and/or that permission would be given for you to attend.
6. You will not be able to gain hands-on experience on an elective placement.

If you would like to spend your elective placement learning more about working with breech presentation, our on-line course is a great place to start. You will gain more exposure to the way breech births work, in a shorter period of time, than most midwives do in their careers. You will gain insight into how women and birthing people can be counselled to ensure informed decision-making. And you will learn how others have implemented change to the way breech works in their local hospitals.

You could structure your own elective placement, including the following:

1. Completing the Physiological Breech Birth on-line training.
2. Working with your local practice development midwives to attend any local training provided to qualified midwives, doctors or medical students, for example mandatory training activities.
3. Arranging to observe local counselling for breech presentation in your antenatal clinic. This may require you to liaise with the Antenatal Clinic Matron to find out about the local breech care pathway.
4. Attending presentation scans. You will need to find out where and by whom these are done in your local unit.
5. Observing external cephalic versions. Where and by whom are these done in your local unit?
6. Reading through publications related to physiological breech birth so you really understand the principals and evidence base.
7. Make a video about some aspect of breech management. If we include it in our training, you get lifetime access for free! Think about what women you encounter need more information about. Or what your fellow students need to learn about breech that you have learned through your placement. Practice finding evidence-based answers to the questions posted to these forums.
8. Hang out on-line in forums related to breech birth, such as Breech Birth Network’s FaceBook page and Instagram, Breech Birth UK, Breech Birth Australia and New Zealand, and the Coalition for Breech Birth. This will give you insight into women’s and providers’ concerns and experiences.
9. Writing a commentary article for a midwifery practice journal, such as TPM’s Student Midwife, summarising your self-made elective placement and what you learned.

Finding out the answers to all of these questions and/or completing these activities will give you insight into how the breech care pathway works for the women you care for. In some locations, this care is provided through an organised clinic and the path is clear. In other sites, care is more fragmented, and it may be harder to determine what the pathway is. But this in itself is useful because you will be able to see the work that needs to be done!

Another benefit of crafting your own placement in your local setting is that, when your colleagues know of your interest in breech, you are more likely to be involved in actual breech births. This is called “attracting breeches,” and you can read more about it in this research.

We are very keen to support students but need to be realistic about how we might be able to do that at the moment.

— Shawn and Emma

Image: Danish midwifery student Pernille Ravn on her elective placement, demonstrating the movement of baby to mother’s abdomen when performing the shoulder press manoeuvre