DESCRIPTION OF TOPIC:
Background: Occiput posterior (OP) malposition is associated with many adverse maternal and neonatal outcomes. Evidence on safe and effective management of malposition is inconclusive; therefore, more trials are needed. Objectives: To assess the feasibility and acceptability of using Sims' posture for OP malposition in labor. Methods: A study that assesses the feasibility and acceptability of a trial of maternal posture for women in labor with sonographically confirmed OP fetal position was proposed and approved. The randomized controlled trial compares the ipsilateral Sims posture to the free posture (excluding the Sims) used from 4cm cervical dilatation and regular contractions till birth. The study will assess rates of screening and recruitment. Maternal satisfaction with trial participation will be assessed using a Likert 5-point scale questionnaire, including free text options. In addition, healthcare providers’ views on study implementation will be assessed using online questionnaires and interviews. The multidisciplinary team of co-investigators was formed two years ago when work commenced on community consultation, embedding indigenous treaty principles, a kaupapa Māori management plan, research design, and related documents, data monitoring, ethics, and funding requests. Following an Auckland Medical Research Foundation grant, the trial commenced at two tertiary-level Auckland hospitals. Results: The study commenced in March 2025, aiming to achieve a sample of 50 participants over a 6-month period, based on current birth rates, incidence of OP, expected missed cases, and expected participation rates. After 3 months, there were 18 recruits. Conclusions: The findings will determine whether a larger multi-center effectiveness trial is feasible. Key message: Trial preparation requires time but ensures effective implementation and recruitment. Ethics and conflicts of interest: Health and Disability Ethics Committee reference: 19149, and locality and institutional approvals obtained. There are no conflicts of interest.

RELEVANCE TO MIDWIFERY:
Sharing a step-by-step approach towards preparing clinical trials provides credible, approachable learning to build confidence and research capacity. Leadership 1 (including three-minute presentation competition)