Reteach breech!

By Breech Without Borders

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A little bit of context

In 2000 a study called the Term Breech Trial concluded that cesarean delivery was much safer than vaginal breech birth. As a result, vaginal breech birth was eliminated almost overnight from most hospitals and the teaching of breech skills ceased entirely.

However, many researchers were not convinced by the TBT. Since 2000 many major studies, mostly in Europe, have refuted the conclusions of the TBT. The short-term risks of vaginal breech birth to the baby are small, and vaginal birth is markedly safer for the mother and her future pregnancies. Obstetric societies in the USA (ACOG), Canada (SOGC), UK (RCOG), Australia & New Zealand (RANZGOC) have all come out in support of vaginal breech birth when attended by a skilled, trained provider.

In an ideal world, obstetric residency programs would have enthusiastically reintroduced breech skills in response to the emerging evidence. But unfortunately this did not happen. By 2016, 94% of all breech presentations in the US were delivered by cesarean section, accounting for 11% of all cesarean deliveries.

Being able to choose whether or not to have surgery is a fundamental legal and ethical right granted to all adults--except pregnant women with breech babies.

That is wrong and we are trying to change it.

Here’s what we’re doing about it

Breech Without Borders' mission is to train doctors and midwives around the world how to safely attend a vaginal breech birth. We are a 501(c)3 nonprofit with two primary goals:

  1. Ensure that every birth attendant can safely and confidently attend a breech birth, knowing when to be hands-off and when to assist with maneuvers, with the mother in the birth position of her choice.
  2. Ensure that every woman, everywhere, has the option of birthing her breech baby vaginally.

To meet those goals, we offer 2-day vaginal breech workshops taught by Dr. David Hayes, MD and Dr. Rixa Freeze, PhD. We have an ambitious schedule and a big world to teach.

How you can help

1) Spread the word to your friends, your family, and your social media.

2) Tell your doctor or midwife about our breech trainings (www.breechworkshop.com) and refer them to the Breech Without Borders website, which has infographics, educational videos, translations, and more: www.breechwithoutborders.org. (We also train EMTs, paramedics, and emergency medicine physicians/nurses!)

3) Donate! Our immediate goal is to purchase two obstetric simulators called Sophie and Her Mum for our training workshops. Each simulator costs nearly $12,000 USD each plus shipping from Australia (where they are made by hand to order). The first one will be ordered when the donation total reaches $12,000.

Once we reach $24,000 (two simulators), additional donations will support other Breech Without Borders projects, including:

  • Breech training workshops: your support will allow us to offer reduced/free admission and bring workshops to resource-poor areas.
  • A prospective cohort study of breech outcomes among providers who have attended our breech workshops. Currently undergoing IRB (ethics) approval.
  • A training video showing breech births side-by-side with 3-D animations illustrating what is occuring inside the mother. This training video will show both normal physiological births as well as obstructed breech births requiring maneuvers.
  • Improvements to Breech Without Borders' website.
  • Translations of all Breech Without Borders materials into multiple languages.

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Team Members

David Hayes

Rixa Freeze

Sarah Tuck

Shannon Mitchell

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