My Care During Pregnancy and Beyond

Yes, in all units. Mothers are advised to phone in or drop in at anytime.

The majority of units encourage mothers to attend antenatal classes. Leaflets are widely available and discussions during antenatal visits are also common.

A small number of units offer information on complementary therapies to help turn breech babies.

A large proportion of units offer ECV (External Cephalic Version) to women who are suitable for the procedure. This involves applying pressure to your abdomen and manually manipulating the baby into a head-down position. The baby is monitored during this procedure.

In some units, if a baby is determined as being breech from 37 weeks a woman is offered a planned caesarean birth. In other units this is offered if methods for turning the baby fail. No unit routinely offers a vaginal birth for breech babies as an option but about half the units reported vaginal breech birth (some of which may have been twins) in their statistics – see table below.

Popup table.

Units reported that typical reasons were; breech and other malpresentations, twins if the first twin is not head down, pre-eclampsia, placenta praevia and two previous LSCS (Lower Segment Caesarean Birth). Two units specified one prior caesarean birth as an indication for a planned caesarean birth and one of those units also specified all multiple pregnancies regardless of the position of the twins. As vaginal birth is generally safer than a caesarean birth a maternal request for a planned caesarean birth will be dealt with on an individual basis normally involving detailed discussion with caregivers.

Clinical reasons listed included babies that were either small for dates or large for dates, high blood pressure, twins & other multiples and any other reasons where there may be concerns for a mother’s and/or a baby’s wellbeing.

A cervical sweep - If you’ve gone past your due date, your midwife may offer to ‘sweep’ your membranes. This involves her inserting a finger gently into your cervix and running it between the top of the cervix and the bag of waters. This has been shown to increase the likelihood of labour starting in the next few days, and to decrease the need for induction, but it isn’t always effective.

Not all units answered this question. Of those that did, one unit stated cervical sweeps are not performed and one other does not have a policy. All other units’ answers varied from 'maternal request', to 'decided on an individual basis with your midwife/doctor' to 'obstetrician’s decision'.

All units except two answered this question. Of the units that answered about half stated they offer induction from term + 10 days with only two references to term+14. The other responses stated this policy varies from consultant to consultant or that the decision is made based on clinical need and/or on an individual basis.