Conclusion
Implementation of physiological breech birth-proficient care within
these settings so far has been achieved through the enablement of a
breech specialist midwife, who leads on service and skill development. A
model of care in which breech services are delivered in dedicated
clinics and flexible intrapartum care teams by specialist midwives,
working in collaboration with obstetric colleagues, is the only model of
service delivery that appears feasible to test in a trial at this time.
Testing OptiBreech Care in a substantive trial will require additional
sites to achieve a similarly adequate level of implementation and
recruitment in a relatively short period of time. Therefore, we have
refined our intervention in the OptiBreech Care pilot trial to reflect
this, to maximise the chances of an efficient and successful trial.