Participating in the National OptiBreech Project

Posted Thursday, 13 October 2022by Natalie Smith

We’re proud to be one of the seven NHS Trusts around the UK, participating in the OptiBreech Project - a national trial set to provide greater support, education and choice to women with ‘breech-presenting babies’, partially funded by a King's ESRC Impact Acceleration Award. Vaginal breech births occur in around 1 in every 200 births in the UK when a baby is born ‘bottom-first’ rather than ‘head-first’.

1 in 25 babies are positioned bottom-first rather than head-first at the end of pregnancy. About 1:10 of these are currently born vaginally.

Kings College London who are sponsoring the research, sharing that 70-80% of breech births can be detected prior to labour, with the remaining 20-30% being detected during the late stages of labour.

The project will support our midwives by providing an opportunity for women to be referred to a ‘breech specialist service’ focusing on offering specialist care and support to mothers whose babies are in the breech position after 36 weeks of pregnancy.

This service will provide counselling about the options available to mothers and, for those who choose to birth their baby vaginally, access to a team of Optibreech Specialists who will be on call to attend their birth.

The research is being funded by the National Institute for Health Research (NIHR), with training to support colleagues in providing greater education to expectant mothers-to-be and to share knowledge on the mechanism of birth.

Shawn Walker, National OptiBreech Research Lead said

"We know that specialist clinics and midwives make a difference by more balanced information, access to experienced breech care professionals and shared responsibility. The research Birmingham Women's are participating in will eventually help us to determine how much they improve outcomes for mothers and babies."

When babies are born ‘bottom first’, the birth mechanism changes, which is why specialist care is needed for mothers to better navigate labour. Offering education on the different choices mothers can make, rather than feeling compelled to have an elective caesarean section or going through External Cephalic Version (ECV). Trying to turn the baby head-down (ECV) is another option, but this only works about half the time.

ECV involves rotating the baby in the womb to have a ‘head-first’ birth. Each mother will be spoken to about the risks, the benefits and the different routes that they can take, specific to the uniqueness of each woman's individual birth journey.

Louisa Davidson, Optibreech Principal Investigator from our Women's Hospital said:

"This service will be available to those women booked at Birmingham Women's Hospital for their birth, to closely monitor the effectiveness of the OptiBreech Initiative. We’re looking forward to expanding our maternity services and will be recruiting for a specialist midwife in Breech Birth to support our Breech Birth Service in the coming weeks."

For more information or to be referred to the service please speak with your community midwife or email Louisa - [email protected]

More information on the OptiBreech Project is available here: https://optibreech.uk/