Capacity & SkillsDiagnosticOperational ExcellenceTraining Upskilling Midwives with Point of Care Ultrasound to Improve Detection of Breech Babies

At the end of the pregnancy, most babies are in a head‑down position, however around 3–4% are breech. At routine late‑pregnancy appointments, fetal position is usually assessed by abdominal palpation, but evidence shows that up to 40% of breech presentations may be missed using this method alone. Undiagnosed breech presentation is associated with increased risks for mothers and babies, including emergency interventions and poorer clinical outcomes. Ultrasound is the gold standard for determining fetal position, but access is often limited to hospital‑based scans performed by sonographers or specialist clinicians.

The NIHR Sono‑breech study contributed to the training of 160 midwives in point‑of‑care ultrasound (PoCUS), improving detection of breech presentation in late pregnancy cases that may otherwise have been missed by abdominal palpation. The findings of this study are expected to inform and support future policy development.

This work has strengthened clinical capability within the maternity workforce and supports earlier and more reliable identification of breech presentation. Earlier diagnosis enables timely referral, improved counselling, and safer birth planning, reducing the risk of undiagnosed breech labour.

The study has great potential impact, with clear scope for adoption into routine practice, improved maternal and neonatal outcomes, and longer‑term cost savings for the NHS through reduced emergency intervention and improved care planning.