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"The Role of the Midwife in supporting women with Breech presentation to have a safe vaginal delivery and the implications for practice"
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As a result, without sufficient training and experience for obstetricians and midwives in managing vaginal breech births, the skills of these practitioners have been reduced. Based on this critical assessment of studies on vaginal breech births, it has been established that there are various factors affecting the incidence of vaginal breech births, lack of experience among birth attendants at the top of the list. Also, the fear of litigation is impacting on the conduct of vaginal breech births. These practitioners are also unwilling to risk the life of the infant by attempting to deliver these infants vaginally. However, as was mentioned, studies have not definitively indicated that caesarean deliveries are actually improving survival rates for breech infants. More studies in line with this research are needed in order to provide specific and definitive results which can be applied in the practice.
This dissertation examines the decreasing use of vaginal breech deliveries, in the context of choice available to women, the experience and expertise of the responsible midwives and the trends toward preferential delivery by caesarean section. This dissertation will be based on the author’s perspective, available evidence and current practice and will further evaluate if the women’s choices with regards to delivery of the breech are significantly impacted by the deskilllling of midwives or by the actual risks of the procedure itself. Current practice, as supported by the NICE and RCOG Guidelines recommends the counselling of women on their possible options for delivery, emphasizing the risks involved in vaginal and caesarean births (Royal College of Obstetricians and Gynaecologists, 2006). Many obstetricians and midwives however have only ever experienced vaginal breech deliveries in a simulated environment, often making vaginal breech births riskier options for women (ROCG, 2006). Since practice is now
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The paper sheds some lights on the vaginal examination in labour, the information that healthcare professionals gather from it, the role of midwives and patients, and the current situation of vaginal examination; whether vaginal examination is a clinical intervention or an essential assessment tool; whether vaginal examination is necessary or it is just a practice by midwives.
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