Emma Spillane, Training Co-ordinator at the Breech Birth Network, has attended six breech births in the last six months in an NHS hospital. Rebuilding breech skill is possible, guided by evidence about how breech competence develops. Emma writes about how she gained confidence in teaching and attending physiological breech births by assisting at Physiological Breech Birth study days.
In January 2017 I attended a Physiological Breech Birth study day in Norwich by Dr Shawn Walker and Dr Anke Reitter. Breech birth had always interested me from my first breech birth as a newly qualified midwife. I didn’t understand the physiology of breech birth at this time, it had always been taught as something abnormal, an obstetric emergency. I could never understand though, how breech birth could be so abnormal if babies were on occasion born like this. My interest had been piqued, and so a few years later, and a few more breech births later, I found myself on the study day to develop my knowledge and skills in vaginal breech birth.
The study day taught me the tools required for supporting women to have a physiological breech birth and to resolve possible complications whilst supporting physiology. Following the training I went and introduced myself to Shawn and told her of my interest in breech birth, I felt so inspired to start a breech birth service within the trust I work. On my return to work I started putting plans in place to develop a service within the trust. Shawn contacted me a few days later and invited me to help teach the hands on clinical skills on her next Physiological Breech Birth training day in South Wales. I jumped at the chance to attend and found it so useful to listen to the day again and then help with the hands on teaching. It helped to embed what I had already learnt previously and give me the confidence to teach the skills within my own trust.
I started talking about breech, a lot! Shawn continued to invite me to help on training days and with each one my confidence grew. I started viewing the videos differently. Instead of looking for what was ‘normal’ and ‘abnormal’ I started analysing them with a deeper understanding of the physiology. Shawn also encouraged me to start teaching parts of the presentation. Admittedly I was more than a little ropey to begin with but with Shawn’s nurturing and encouragement and the more I learnt from each training day, each time I attended my confidence grew. Eventually I was able to transfer this new knowledge, understanding and confidence into practice. I was asked to attend a breech birth!
I supported a woman with a physiological breech birth, along with a consultant obstetrician colleague and one other midwife. An arm complication occurred with the birth, and I was able to resolve using the manoeuvres I had learnt and taught on the course. The baby was born in good condition, and I felt relieved and elated! I immediately contacted Shawn to tell her about the birth but it had also sparked an interest in the consultant obstetrician who had attended. We debriefed from the birth and I spoke about the Breech Birth Network and the training it offers. I took the opportunity to ask if my obstetric colleague would like to be the lead consultant in my quest to set up a breech birth service, to which they agreed. It had taken me nine months – the length of a full term pregnancy – from when I first attended the training until this physiological breech birth. It was the birth of an exciting change in knowledge and culture.
Attending training days has not only helped to embed my own learning but it has given me the skills and confidence to set up a service within the trust I work, support women who choose to have a vaginal breech birth and support colleagues to facilitate breech births themselves. I have found repeating the information and skills has been the key to my learning and enabling change within practice. It has given me the confidence to attend births and increased the number of breech births within the trust by instilling confidence in others. If you would like to build your confidence in vaginal breech birth, develop a service within your trust and teach others I highly recommend coming along and helping at future training days. Please let us know by getting in contact via email or the contact form.
Research indicates that providing teaching is an important part of the development of breech expertise. Read more: Expertise in physiological breech birth: A mixed-methods study