Session 3: Breech maneuvers from 1609 to the present
- Duration: 60 Mins
- Credits: 0.3 Midwifery CEU, 3 ACM CPD Hours, 3 ACNM
- Learning Format: Webinar
- Handout: No
Abstract:
For more than four centuries, midwives and physicians have documented maneuvers to assist breech births. This lecture reviews all named obstetric breech maneuvers, which vary by technique and popularity, but all involve a supine mother with an immobile pelvis and a baby emerging against gravity. The lecture documents a new approach to vaginal breech birth: upright birth with mother and baby actively participating in the process. This biodynamic approach combines gravity, maternal movement, and a baby assisting in its own birth to create optimal conditions for a successful vaginal breech birth. I discuss recent studies documenting how upright breech birth leads to shorter labors, fewer birth injuries, fewer maternal injuries, and fewer maneuvers compared to supine breech birth. Because upright breech birth has easily recognizable mechanisms, which I will cover briefly in the lecture, providers can confidently know when the progress is unfolding normally ("Respect the mechanism") and when assistance is needed ("Restore the mechanism"). The lecture, I introduce and demonstrate maneuvers have been developed specifically for upright breech birth when the birth deviates from normal.
Learning Objectives:
At the end of the session the participant should be able to:
Objective 1: Identify the main types of obstetric maneuvers for vaginal breech birth developed over the past 4 centuries.
Objective 2: List the 10 mechanisms of spontaneous upright breech birth.
Objective 3: Identify deviations from the normal mechanisms.
Objective 4: List the appropriate maneuvers, adapted for upright positions, to restore the mechanisms back to normal.
Objective 5: Summarize the research evidence for breech birth in an upright position.
