BACKGROUND:
Gaining skill and experience in vaginal breech birth (VBB) is essential in midwifery. However, because training opportunities are few and vaginal breech birth (VBB) occurs relatively infrequently, many attendants struggle to gain expertise. Additionally, there is debate about intervention timing in VBB. Combining video analysis with simulation training helps bridge knowledge gaps.

OBJECTIVES:
We explored the use of video recordings in analysing breech births, highlighting critical insights that real-time observation often misses. By reviewing expulsive stages through detailed video analysis, we provide birth attendants with valuable opportunities for learning and skill enhancement.

METHODS:
We analysed 207 singleton non-supine VBB birth videos, from rumping to birth. A minimum of two researchers reviewed each video to agree on timing of physiological fetal manoeuvres, maternal positions, interventions and manoeuvres uses and observations of fetal condition. Any disagreement on the analysis were resolved via team consensus.

RESULTS:
Our study showed that expulsion in a physiologic breech birth is dynamic. Despite averaging a few minutes, about 25% of women make position changes during the expulsive phase to facilitate birth. Our study does not prescribe specific manoeuvres or set time frames for births. Our research indicated that continual assessment of fetal condition for signs of vigour and expedition of birth if fetal compromise is suspected rather than allowing specific time frames is more appropriate. We observed that assistance for legs/trunk is rare, while arm/head assistance is more common. Extensive assistance for arms/head occurs in about 8-10% of upright breech births, highlighting the need for ongoing training.

CONCLUSIONS:
Our study emphasises the educational value of birth videos in conjunction with simulation training, for developing knowledge in breech birth mechanism. We address evolving debates surrounding time-based intervention algorithms, re-evaluating traditional teachings about VBB mechanics in upright maternal positions.

KEY MESSAGE:
Reviewing VBB videos improves individual recognition of deviations and supports ongoing professional development. Poster session 4 (Group B)