Caboolture Hospital, McKean Street, Caboolture, Queensland 4510, Australia.
University of Southern Queensland, School of Nursing and Midwifery, Queensland 4305, Australia.
Women Birth. 2020 Jul;33(4):e348-e356. doi: 10.1016/j.wombi.2019.08.002. Epub 2019 Aug 24.
Australian women seeking a vaginal breech birth report limited access to this option due to resistance from clinicians and strict medical criteria. Limited evidence exists to determine the attitudes, knowledge, experience and perceived confidence of Australian maternity clinicians towards the management of a breech presentation at term.
The aim of this study is to identify experience, knowledge and attitudes of birth suite clinicians' before and after training, toward term breech presentation and management practices.
A mixed methods research design was used that included a survey tool. A survey of 29 midwives and 11 medical professionals who attended an educational course in breech management ("BABE - Becoming a Breech Expert") was undertaken pre and post BABE training.
While participants were experienced in providing maternity services, the results indicated most were inexperienced in facilitating a vaginal breech birth. Prior to training, most participants believed vaginal breech birth had a higher risk of neonatal morbidity and mortality compared to caesarean birth. The prospect of a woman choosing a breech birth outside of medical recommendations made many participants "nervous". Despite this, support to ensure there was informed decision-making and respect for a woman's choice was high. Following training, clinician knowledge of assessment of risks for breech birth and intention to discuss breech management options with women increased.
Participation in breech management training is beneficial to increasing clinician knowledge and assessment of risk and confidence towards discussing vaginal breech birth management, respect for women's choice and informed decision-making.
澳大利亚的女性希望选择阴道臀位分娩，但由于临床医生的反对和严格的医疗标准，她们的这种选择受到限制。目前，关于澳大利亚产科临床医生对足月臀位的管理态度、知识、经验和自我效能感的证据有限。
本研究旨在确定分娩套房临床医生在培训前后对足月臀位的经验、知识和态度，以及他们对臀位管理实践的态度。
采用混合方法研究设计，包括调查工具。对参加臀位管理教育课程（“BABE-成为臀位专家”）的 29 名助产士和 11 名医疗专业人员进行了调查。
虽然参与者在提供产科服务方面经验丰富，但结果表明，他们在促进阴道臀位分娩方面经验不足。在培训之前，大多数参与者认为阴道臀位分娩比剖宫产分娩新生儿发病率和死亡率更高。许多参与者对女性选择违反医疗建议的臀位分娩感到“紧张”。尽管如此，他们还是支持确保有知情决策，并尊重女性的选择。培训后，临床医生对臀位分娩风险评估的知识以及与女性讨论臀位管理选择的意愿有所增加。
参加臀位管理培训有助于增加临床医生的知识和评估风险的能力，并增强他们在讨论阴道臀位分娩管理、尊重女性选择和知情决策方面的信心。
