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.
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.
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
