Program

Nurse-Midwifery M.S.

Number of Pages

46

Year Approved

2024

First Advisor

Hardy, Paige

Second Reader

Julie Ann Vingers

Abstract

Introduction: Vaginal breech birth has declined since the Term Breech Trial in 2000 because of study outcomes showing higher adverse outcomes for the neonate in vaginal breech births (VBB) when compared to cesarean sections. Recent literature, however, shows that maternal morbidity and mortality are high with cesarean section compared to VBB. Modern delivery providers have limited knowledge, education, and skills in VBB, which ultimately leads to limited delivery options for women. Providers should be aware that informed consent includes discussing all options for management, including VBB, external cephalic version, and cesarean section, as well as the short-term and long-term implications of the birth method on the neonate in order for proper shared decision-making (SDM) to occur. Research Aim: The purpose of this literature review was to reveal the lived experiences of women diagnosed with breech positions in pregnancy and their role in the SDM process regarding mode of delivery. Methods: A systematic search in PubMed, CINAHL, and Nursing and Allied Health resulted in 22 original studies. Inclusion criteria were women with lived experiences of having breech-positioned fetuses, years 2014–2024, and U.S and international studies. Exclusion criteria were articles not in English, articles irrelevant to SDM in pregnancy, articles that did not include participants with breech diagnosis, and articles published before 2014. Study results were organized to reflect four main themes found throughout the literature: emotional response, choice in care, influences on informed consent and SDM, and outcomes related to limitations on SDM. Results: Women and birth providers have negative emotions when presented with a breech-positioned fetus, the majority of women have limited choice in delivery mode, the majority of influencers (e.g., media outlets, social support, medical staff) are not supportive of VBB as an option in care, and lastly, the outcomes of limited informed consent and SDM limit delivery options and may lead to women seeking VBB in areas not supported by national guidelines. Discussion: The choice to have a VBB is not often presented as a valid delivery mode. Using an SDM model will support discussions that include VBB, external cephalic version, and cesarean section as management options for a breech-positioned fetus and choice for mode of delivery.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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