Pregnant women's preferences and knowledge of term breech management, in an Australian setting

Abstract

Objective: to assess women's familiarity with breech presentation and external cephalic version (ECV), and to identify women's preferences and attitudes regarding breech management. Design: cross-sectional survey. Setting: King George V (KGV) Memorial Hospital for Mothers and Babies, Sydney, Australia, a major metropolitan teaching hospital. Population: 174 pregnant women (20–38 weeks gestation) attending KGV for antenatal care in 2001. Methods: data were obtained from a self-administered questionnaire that was distributed through the antenatal clinics. Main outcome measures: women's familiarity of breech presentation and ECV, women's attitude towards ECV, decision to attempt ECV, and with whom participants would like to make a decision regarding ECV. Findings: of the 174 respondents, 85% could correctly identify breech presentation, and 66% had heard of ECV. For 87% this information was from books, and family/friends, and not their midwife/doctor. Equal numbers of women responded that they would or would not choose ECV (39%), and the remaining 22% were uncertain. Factors influencing their decision included concerns about the safety for the baby, ECV not guaranteeing vaginal birth despite successful version, and ECV not being effective enough. Seventy-two per cent wanted to make the decision to attempt ECV together with their doctor. Conclusion: although the majority of the women had a preference for vaginal birth, their knowledge of ECV appeared insufficient to enable them to make informed decisions about attempting ECV. These findings suggest that care-providers should offer women information on ECV, in a shared-decision-making environment.