{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:30:46Z","timestamp":1764333046596,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The \u201cphysiological breech birth\u201d one\u2010day training program is based on evidence about the physiology of breech births and how clinicians learn breech skills. Previous evaluations have demonstrated positive effects on confidence and knowledge, but the training's effect on clinical practice and outcomes is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A mixed\u2010methods evaluation was conducted in eight National Health Service hospitals in England and Northern Ireland. Changes in confidence and knowledge were assessed using pretraining and post\u2010training surveys. Mode of birth and maternal birth positions were evaluated using audit data covering one year before the training and one year after, for all singleton vaginal breech births at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 263 participants completed the surveys. Confidence in managing breech births in both upright and supine positions significantly increased, as did participant knowledge. Audited data for 1402 women were collected. Overall vaginal birth rates remained similar in both periods. Among singleton vaginal breech births &gt;37\u00a0weeks, the use of upright birthing positions increased significantly (<jats:italic>P<\/jats:italic> = .002). The study was not powered to detect differences in other outcomes, but pilot data were collected to inform the design of future studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increase in use of upright birthing positions suggests that physiological breech birth training is likely to lead to clinical practice changes, which may help support maternal choice in line with current guidance. However, provision of a one\u2010day training program did not change overall vaginal breech birth rates. Adequately powered research is needed to determine effects of clinical practice changes on clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12562","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T09:50:06Z","timestamp":1624441806000},"page":"558-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Physiological breech birth training: An evaluation of clinical practice changes after a one\u2010day training program"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-8193","authenticated-orcid":false,"given":"Stella","family":"Mattiolo","sequence":"first","affiliation":[{"name":"Women\u2019s and Children\u2019s Health, Epsom and St Helier University Hospitals Epsom UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Spillane","sequence":"additional","affiliation":[{"name":"Kingston Hospital NHS Foundation Trust Kingston UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-8988","authenticated-orcid":false,"given":"Shawn","family":"Walker","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health King\u2019s College London London UK"},{"name":"Chelsea and Westminster Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1111\/1471-0528.14465"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1016\/j.jogc.2018.12.018"},{"unstructured":"NICE.Intrapartum care for women with existing medical conditions or obstetric complications and their babies(NG121);2019.https:\/\/www.nice.org.uk\/guidance\/ng121\/. 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