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Into the Breech

Melbourne: Thursday Dec 5th 2013


Vaginal breech birth will inevitably occur, whether planned or unplanned. However, due to the current obstetric practice to schedule all breech presentations for caesarean section, skills in vaginal breech birth are now lacking. Into the Breech will address the clinical evidence about the safety of vaginal breech birth and the best practice for clinicians who support women in vaginal breech birth, whether diagnosed or undiagnosed. The course will cover the mechanisms of physiological breech birth; how and when to help when the breech does not descend; and original research about the differences in women’s pelvises and the outcomes for mother and baby when birthing in upright positioning. Into the Breech provides up to date information about opportunities to access vaginal breech birth in Australia and the set-up of specialist breech clinics, here and internationally. It also includes a medico-legal discussion of the requirements of informed consent both to vaginal breech

Melbourne - Thu 05-Dec-2013
08:30 AM Registrations - tea and coffee
08:50 AM Welcome and introductions
09:00 AM Women’s experiences of breech birth in Australia - Dr Rhonda Tombros
09:10 AM Presenting breech (research re management of breech presentation, including undiagnosed breech and women’s experiences of breech) - Shawn Walker
09:40 AM Mechanisms of normal breech birth - Dr Anke Reitter
10:20 AM Hands and knees position - The Frankfurt experience - Dr Anke Reitter
11:00 AM Morning tea
11:20 AM When and how to help (with videos/photos) - Shawn Walker
12:00 PM MRI Research - Dr Anke Reitter
12:40 PM Lunch
01:30 PM Workshops (an apportunity to practice the mechanisms and helping
02:30 PM Informed consent to breech birth (The legal requirements of informed consent to both CS and VBB- helps protect practitioners) - Dr Rhonda Tombros
03:00 PM Afternoon tea
03:20 PM Breech pathways in Australia - Michelle Underwood
03:50 PM The Paget HeadsUp! Breech Pathway - Shawn Walker
04:30 PM Close
SPEAKERS: Dr Andrew Bisits, Michelle Underwood, Dr Rhonda Tombros, Dr Anke Reitter, Shawn Walker
Dr Andrew Bisits
Dr Andrew Bisits

Andrew is a Senior Staff Specialist at the Royal Hospital for Women in Sydney, Australia. Previously he was Medical Director of Obstetrics at John Hunter Hospital, another large teaching hospital in Newcastle, NSW, Australia. He has been a strong support for, and respectful advocate of, midwives and midwife-centred care for many years. One ofhis interests is keeping alive skills for vaginal breech births, Papers about his experiences have been published in professional journals and as part of the International Vaginal Breech Trial Study.



Michelle Underwood
RM, Dip Mid, MSc

Michelle has been a midwife since 1995. She was among the first cohorts in the UK to do direct entry midwifery. She practised at St Mary’s Hospital, Manchester, a large tertiary referral centre for 10 years before moving to Stepping Hill Hospital to become an Advanced Midwife Practitioner (AMP) for 5 years. Michelle came to Sydney in 2009 first working at the birth centre, Royal Prince Alfred hospital before taking up the position of Clinical Midwifery Consultant at Westmead. One of her first

jobs was to set up the breech clinic with Dr Andrew Pesce. Now that the breech clinic is established, they are currently developing homebirth and next birth after caesarean services.



Dr Rhonda Tombros
BA, LLB, LLM, DPhil (Oxon)

Rhonda is a human rights lawyer, currently working at Melbourne Law School and Mother & Child Health Research, La Trobe University. She has an interest in a variety of medico- legal issues related to childbirth. As a result of her own experience in carrying a breech- presenting baby, Rhonda formed Breech Birth Australia and New Zealand (www.breechbirth. net), a consumer support group for the mothers of breech babies. Rhonda is qualified to practice as a lawyer in New Zealand, England and Australia. 


Dr Anke Reitter

Anke is a senior OBGYN in clinical practice at the University Hospital of Frankfurt. Anke was born in Frankfurt, Germany. She studied medicine in Germany and qualified after first working in Great Britain. During her studies Anke worked in India and the United States. She got her first working experience as a doctor in England, practicing there for 4 years. She successfully completed her training with becoming a memberof the Royal College of Obstetrician and Gynaecologist (RCOG). Returning to Germany, she became a specialist in perinatal medicine. Since 2003 she has practiced in the Obstetrics and Gynaecology department at the University Hospital Frankfurt. Her special interest lies in breech, multiple pregnancies,high risk pregnancies and prenatal ultrasound. In September 2012 she became a Fellow of the RCOG. From October 2013 she is joining Andrew Bisitis team at the UNSW for 6 months as a research fellow.



Shawn Walker
Shawn Walker

Shawn Walker is a midwife who researches how to make vaginal breech birth safer, how to nurture competence and expertise and the philosophy of physiological breech birth methods.

She is a Senior Research Fellow at King’s College London and a Consultant Breech Specialist Midwife at Chelsea and Westminster NHS Hospitals Trust.