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Research as Leadership

Dr Shawn Walker

Midwifery Lecturer and Breech Specialist Midwife

04 May 2020

Health

In honour of International Day of the Midwife 2020, I would like to share my view of ‘Research as Leadership.’

Vaginal breech birth has been controversial forever. Even when it was ‘the done thing,’ it was controversial. After observing the coercion many women felt to have a planned caesarean, I wanted to make this better. However, I could also see that the risk associated with vaginal breech birth is not an obstetric myth. It is very real, and although some professionals may seem dogmatic or patronising, it often comes from a desire to avert suffering.

The way out of this stalemate required leadership. And leadership requires listening to the concerns of all stakeholders.– Shawn Walker

Childbearing people clearly deserve a reasonable choice of how to give birth to their babies, but professionals could not give them a reasonable choice with the current skills and learning opportunities available to them.

So, in addition to developing my own skills to support vaginal breech births and perform external cephalic versions, I set about answering the questions that, unanswered, were barriers to midwives and obstetricians providing a high standard of care.

Each of these questions is a small piece of a very large puzzle, which adds up to my vision of the way forward: A service in which women have a real choice because vaginal breech birth services are provided as safely as possible.– Shawn Walker

Here are my questions

What training, skills and experience do midwives need to incorporate external cephalic version safely into their sphere of practice?
What training, skills and experience do midwives and obstetricians need to incorporate upright breech birth into their practice?
What are the underlying principles guiding physiological breech birth practice?
Some professionals in current practice seem to be able to develop skill and experience with vaginal breech birth, while others do not? How do those who acquire skill and experience do it?
What does the published evidence say about the impact of breech training?
How do professionals accustomed to training on assisted breech delivery in supine maternal positions evaluate a physiological breech birth training package designed on this research?
How does physiological breech training change professional behaviour and outcomes for mothers and babies? (Coming soon!)
What features to upright breech births with good outcomes share in common?
How do professionals use the Physiological Breech Birth Algorithm in practice?