Clinical Implications From an Exploratory Study of Postural Management of Breech Presentation


  • Sandra A. Founds CNM, FNP, PhD

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    • Sandra Founds, CNM, FNP, PhD, is Assistant Professor at the University of Pittsburgh School of Nursing.

Sandra A. Founds, CNM, FNP, PhD, Department of Health Promotion and Development, University of Pittsburgh School of Nursing, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261. E-mail: or


The results from an exploratory study of the effectiveness of maternal knee-chest posture for producing cephalic version of breech presentation are shown. Methods are briefly described and clinical implications are presented. Among 25 women, fewer who performed the maternal knee-chest postural intervention experienced fetal cephalic version than women in the control group who did nothing to influence breech presentation. Despite limitations of the underpowered findings, trends in the data may indicate that parity and gestational age were potentially relevant covariates of version. Postural management is not an evidence-based practice. This exploratory study indicates that maternal knee-chest posture may work opposite to the expected direction, but the small sample size precludes generalizations about efficacy of knee-chest postural management. At least one adequately powered trial that controls for parity and gestational age is needed to determine whether knee-chest postural management results in no effect, a small, or small to moderate clinically significant effect.