Breech Antenatal Class

LOCATION:

This class takes place within the Royal London Hospital on Whitechapel Road, on 8C (Antenatal Clinic), in the Elizabeth Major Seminar Room.

These classes are FREE to women booked to give birth within Barts Health hospitals (Royal London, Whipps Cross, Newham).

For those who are unable to attend in person, a Teams link will also be sent to enable participants to attend virtually if necessary.

DESCRIPTION

This class will help you prepare for a vaginal birth. Topics we will cover include:

• How you can prepare for this type of birth.
• Birth movements and positions that can help your baby be born.
• What to expect -- hospital guidelines about care for breech babies.
• What are your choices? What matters to you?
• Potential complications -- what could happen, and how your birth attendants will help
• Care following birth, in hospital and at home
• Any other questions?

If you wish, you can access the free OptiBreech Evidence Base 2025 online course prior to attending the training.

Facilitator:

Shawn Walker, RM, PhD is a Consultant Midwife for Public Health at The Royal London Hospital. She has researched how to improve competence, confidence and safety in vaginal breech birth for over 15 years. As a previous NIHR Advanced Fellow and Chief Investigator of the OptiBreech Trial, Dr Walker led the only UK-based multi-centre breech study, a feasibility study of a new care pathway for women pregnant with a breech-presenting baby at term (https://optibreech.uk). She has lead the vaginal breech birth and external cephalic version training segment of the RCOG Management of Labour Ward course for the past four years.

References

Walker S, Das S, Stringer K et al. How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved]. NIHR Open Res 2023, 3:61 (https://doi.org/10.3310/nihropenres.13500.1)

Walker S, Spillane E, Stringer K, et al. OptiBreech collaborative care versus standard care for women with a breech-presenting fetus at term: A pilot parallel group randomised trial to evaluate the feasibility of a randomised trial nested within a cohort. PLoS One. 2023;18(11):e0294139. doi:10.1371/JOURNAL.PONE.0294139

Shetty SS, Walker S, Fox-Rushby J, Managing uncomplicated singleton breech pregnancy using ‘OptiBreech collaborative care’ pathway: early economic model and value of information analysis, Value in Health (2025).

Davies SM, Hodder A, Walker S, Bale N, Vincent H, Dasgupta T, et al. The OptiBreech Trial Feasibility Study: A Qualitative Inventory of the Roles and Responsibilities of Breech Specialist Midwives. Journal of Midwifery & Women’s Health. 2025 (online early view).

Vincent H, Walker S, Hodder A, et al. Barriers and facilitators for implementation of OptiBreech collaborative care: A qualitative study as part of an implementation process evaluation. Women and Birth. 2024;37(5):101656. doi:10.1016/J.WOMBI.2024.101656

Walker S, Spillane E, Stringer K, Meadowcroft A, Dasgupta T, Davies SM, Sandall J, Shennan A, Batish A, Davidson L, Das S, Magurova L, Haroun G, Meates C, Houghton G, Le Grys H, 2023. The feasibility of team care for women seeking to plan a vaginal breech birth (OptiBreech 1): an observational implementation feasibility study in preparation for a pilot trial. Pilot Feasibility Stud. 9, 80. https://doi.org/10.1186/s40814-023-01299-x

Dasgupta T, Hunter, S, Reid, S, et al. Breech specialist midwives and clinics in the OptiBreech Trial feasibility study: An implementation process evaluation. Birth. 2022; 00: 1- 10. doi: 10.1111/birt.12685 – The full study exploring the acceptability of proficient breech team care for women. Be sure to read the supplementary file containing quotes from women who participated in the research.

Walker S, Dasgupta T, Halliday A, & Reitter A (2021). Development of a core outcome set for effectiveness studies of breech birth at term (Breech-COS): a systematic review on variations in outcome reporting. European Journal of Obstetrics & Gynecology and Reproductive Biology.

https://twitter.com/sheena_byrom/status/1659198509642563585?s=20

Additional publications:

Walker S, Daelemans C, Gerhard-Nielsen K, Das S, Page L. Variations of cervical head entrapment in vaginal breech births: New insights on how to prevent, manage and resolve. Eur J Obstet Gynecol Reprod Biol. 2024;299:78-82. doi:10.1016/j.ejogrb.2024.05.039

Bresson J, Christie K, Walker S, 2023. Not too fast, not too slow: A review of historical trends in vaginal breech time management. Eur J Obstet Gynecol Reprod Biol 287, 216–220. https://doi.org/10.1016/j.ejogrb.2023.06.015

Roy R*, Gray C*, Prempeh-Bonsu CA and Walker S, 2023. What are women’s experiences of seeking to plan a vaginal breech birth? A systematic review and qualitative meta-synthesis [version 1; peer review: awaiting peer review]. NIHR Open Res 2023, 3:4 (https://doi.org/10.3310/nihropenres.13329.1) * Joint first authors

https://twitter.com/AliOtter/status/1617256954291707913?s=20&t=o-0vJqVK7ZWZjJ0UOa98Pg

Walker, S., Roberts, P., Boulding Harriet, 2022. Breech Clinics and Specialist Midwives Toolkit [WWW Document]. OptiBreech Project Blog. URL https://optibreech.uk/2022/09/18/breech-clinics-and-specialist-midwives-toolkit/(accessed 12.24.22).

Spillane E, Walker S and McCourt C. Optimal time intervals for vaginal breech births: a case-control study [version 2; peer review: 1 approved, 2 approved with reservations, 1 not approved]. NIHR Open Res 2022, 2:45 (https://doi.org/10.3310/nihropenres.13297.2)- Research by our lead investigator at Kingston Hospital.

Das S. (2023) Resurrecting a lost obstetric skill to reduce global maternal death. BMJ Global Health Blog. — Miss Das is our lead investigator at Queen Charlotte’s and Chelsea Hospital.

Timmons P, Wallis V, Walker S and Alleemudder D, 2022. Management of term breech presentation. Obstet Gynecol. 25(1):8-18. – An update article for professionals.

STUDY DAY AGENDA:

09:00_____ Welcome & housekeeping

09:15_____ Introduction to principles of physiological breech birth

09:45_____ Management of labour

10:45_____ BREAK

11:15_____ All about the legs

11:45_____ Cross-body arm sweep

12:15_____ Rotational manoeuvres for extended arms

13:00_____ LUNCH

14:00_____ Shoulder press

14:30_____ Scoop and Flex and Forceps

15.00_____ Complex and extended heads

15.30_____ Video case reviews and practice

16.00_____ FINISH