title: Care during the decision-making phase for women who want a vaginal breech birth: Experiences from the field.
abstract: BACKGROUND
  few women are given the option of a vaginal breech birth in Australia, unless the clinicians feel confident and have the skills to facilitate this mode of birth. Few studies describe how clinicians provide care during the decision-making phase for women who choose a vaginal breech birth. The aim of this study was to explore how experienced clinicians facilitated decisions about external cephalic version and mode of birth for women who have a breech presentation.
  
  
  METHODS
  a descriptive exploratory design was undertaken with nine experienced clinicians (obstetricians and midwives) from two tertiary hospitals in Australia. Data were collected through face to face interviews and analysed thematically.
  
  
  RESULTS
  five obstetricians and four midwives participated in this study. All were experienced in caring for women having a vaginal breech birth and were currently involved in providing such a service. The themes that arose from the data were: Pitching the discussion, Discussing safety and risk, Being calm and Providing continuity of care.
  
  
  CONCLUSIONS
  caring for women who seek a vaginal breech birth includes careful selection of appropriate women, full discussions outlining the risks involved, and undertaking care with a calm manner, ensuring continuity of care. Health services considering establishing a vaginal breech service should consider that these elements are included in the establishment and implementation processes.
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia. Electronic address: Christine.catling@uts.edu.au.
authors.forename: C
authors.initials: C
authors.lastname: Catling
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Petrovska
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
authors.forename: N P
authors.initials: NP
authors.lastname: Watts
authors.affiliation: Royal Hospital for Women, Randwick, Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Bisits
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
authors.forename: C S E
authors.initials: CSE
authors.lastname: Homer
mesh_terms: D001291:Attitude of Health Personnel; D001946:Breech Presentation; D003657:Decision Making; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery; D010820:Physicians; D011247:Pregnancy; D011295:Prenatal Care
keywords: Decision-making; Mode of birth; Qualitative research; Risk; Vaginal breech birth