Midwives’ views, experiences and feelings of confidence surrounding vaginal breech birth: a qualitative study
Ruth Sloman, Marta Wanat, Ethel Burns and Lesley Smith
Barts Health NHS Foundation Trust, UK
: J Womens Health, Issues Care
Abstract
Background: Midwives in the UK are required to have skills in vaginal breech birth (VBB), yet there is concern about its safety due to its low incidence and the subsequent loss of skills. However, VBB occurs in practice through maternal choice, and women presenting undiagnosed in labour. Objective: To explore midwives’ views, experiences, and feelings of confidence surrounding VBB. Design: A qualitative study was conducted with 12 participants using three focus group discussions. Data were transcribed verbatim and thematic analysis was used to analyze the data. Setting: UK midwives were recruited from different geographical areas and worked in community areas, hospital areas and as independent practitioners. Findings: Three themes were identified. Firstly, midwives viewed VBB in dimensions of normality. They perceived upright positions to facilitate VBB, and that VBB should not be automatically treated as an emergency. However, midwives acknowledged potential problems and therefore preferred to be in a hospital environment. Secondly, midwives expressed varied feelings of preparedness; the majority feeling inexperienced and under-prepared with VBB, yet more confident when supported by other colleagues. Lastly, midwives described restrictions on women’s choice of VBB; perceiving other practitioners as limiting women’s choices through coercion, yet providing a balanced choice themselves. Conclusions: There should be an opportunity for midwives to be mentored by a more experienced practitioner in VBB. Practice areas should develop a guideline for VBB which acknowledges the role of the midwife in facilitating normal breech birth. Balanced written and verbal information on VBB may further assist decision making for women considering a VBB. Education in VBB should focus on learning what is normal for VBB and must emphasize the importance of teamwork and understanding roles within multidisciplinary teams.
Biography
Ruth Sloman conducted her research on breech birth during her Midwifery Master’s study program. She qualified as a Midwife in July 2014. She is especially interested in maternal/women’s health in resource-poor settings. From January 2016-January 2017, she returned to the same hospital in Uganda and worked as a volunteer in the maternity department and educating students in the School of Nursing. She has started a Community/Birth Centre Midwife post at Royal London, Whitechapel, in May 2017.
