When we talk about the complexities of pregnancy, a breech presentation is on the top of the list. Vaginal breech birth becomes reality when a team of expert midwives and obstetrics working together. Shawn Walker sharing her expertise in vaginal breech birth she gained in her vast experience while associated with King’s College London and NHS.
Shawn Walker shared her expertise in vaginal breech birth and her vast experience gained through her association with King’s College London and the National Health Service (NHS). Vaginal breech birth becomes more successful when there is an expert team and obstetricians working together as per Walker. She added that breech presentation remains on top of the list and is a midwife specializing in the field of physiological vaginal breech birth and clinical research in this field. Her NHS fellowship covers research on feasibility of physiological breech birth methods.
Day to day clinical work involves presentation scans if women have been referred for suspected breech presentation while counseling them about available options, possibilities involving turning the baby’s head down with pressure on the abdomen and taking crucial decisions regarding opting for C-sections or vaginal breech birth methods. Obstetricians have to tackle additional risk factors in this regard. She emphasized upon the special skills needed for turning the baby head down and referred to her extensive training programs for trainee doctors and other midwives in this field. She is also doing internal and external research related to using tests for determining the effect of intervals and timings between the birth of the pelvis and the birth of the head and vital time around birth and whether delays are linked to any adverse outcomes.
Breech presentation chose her as per Walker and she initially practiced as an independent midwife outside the aegis of the NHS. Women started coming to her for enabling breech births and this was an area which required more expertise as she discovered. Instead of independently plunging into the same, she went within the NHS system since she felt this was the safest way of enabling breech births while working with obstetricians and neonatal colleagues for providing all available options to women suffering from sudden complications.
The poignancy of the process is not lost when Walker states that there is no overnight solution and intensive surgical intervention may be needed at times. Being the first to get the title of Breech Expert in the UK, Walker knows that the success rate may be just 50% for practitioners if they are turning the baby head down while evidence does not indicate any adverse risks and specific outcomes alike in this scenario. Turning the baby, according to Walker, is more about increasing the chances of a woman for vaginal breech birth instead of enhancing outcomes for breech babies themselves. Most women find it very bearable although emotional support cannot be ruled out at any stage.
With bigger babies, the risk is mostly for mothers since they are usually resilient in labor but mothers have more chances of undergoing C-sections while in labor as a result. Pre-labor C-sections are often preferred since risks of mothers are higher when they go into labor. First-time mothers sometimes have babies with extended breech or legs and they may plateau somewhere around 6 or 9 cm just because the baby has to turn a little and wriggle the hips through the pelvis. The legs get splinted at times and it gets hard to turn around this curve. This necessitates decisions to opt for C-sections at times. When the second stage is very long, that may lead to higher risks for the baby too and when there are natal heart rate issues then that is an emergency call for a C-section without any calm decision making and discussions going into the procedure.
Walker’s journey clearly indicates the intricacies and complexities involved in the nature of what she does and how it is directly linked to the successful birth of healthy children and the wellbeing of delivering mothers. Similarly, Catton’s insights clearly illustrate how nursing personnel are in short supply and need to be educated, cared for and respected while deploying investments in nursing education and growing the workforce.