THE LEARNING OUTCOMES:
Participants will be able to identify signs of a deflexed/extended breech head in the pelvic outlet when the woman is in an upright position (standing, hands & knees, kneeling, etc.) Distinguish between a head trapped in the pelvic inlet and pelvic outlet Describe and correctly perform two maneuvers to help release a stuck head in the pelvic outlet

THE PROCESS/ACTIVITIES:
“What if the head gets stuck?” is a common fear during a vaginal breech birth. A deflexed head in the pelvic outlet is the most common complication during a vaginal breech birth. This skills workshop teaches how to identify the signs of a deflexed head in the pelvic outlet, as distinguished from the more rare pelvic inlet head entrapment, as well as presents two evidence-based maneuvers to release the head: shoulder press and Crowning Touch. We first present videos and photos of deflexed heads, pointing out the signs of a deflexed or extended head. Next, we explain and demonstrate the two maneuvers using a Sophie and Her Mum obstetric simulator and a doll & pelvis. We also show the maneuvers being used in real-life situations using breech birth videos. Finally, participants practice the maneuvers on a simulator and with a doll & pelvis, under the supervision of the instructors.

AUDIENCE PARTICIPATION:
The audience will actively participate via hands-on simulation training using a simulator and a doll & pelvis. They will also be invited to ask questions and discuss the birth videos. Additional reading Reitter A, Halliday A, Walker S, et al. Practical insight into upright breech birth from birth videos: a structured analysis. Birth. 2020;47(2):211-219. Freeze R, et al. A Guide to Physiological Breech Birth. 2nd ed. Breech Without Borders; 2024. Daviss BA, et al. Can forceps be eliminated in vaginal breech by using upright positions and the “crowning touch” manoeuvre? Presented at: FIGO World Congress 2021; October 21-28, 2021.