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Keywords:

  • breech;
  • external cephalic version;
  • trial participation;
  • women’s decision-making

Abstract:  Background:  The international, multicenter External Cephalic Version 2 (ECV2) Trial compared early external cephalic version at 340/7 to 356/7 weeks with that at greater than 37 weeks. A total of 1,543 women were randomized from 68 centers in 21 countries. The goal of this component of the trial was to understand women’s views about participation in a research trial and timing of external cephalic version.

Methods:  A postpartum questionnaire was completed containing a 5-point Likert scale examining contact and availability of staff, choice of timing of external cephalic version, preference of randomization, convenience of participating, and overall satisfaction. Participants also completed two open-ended questions related to timing of external cephalic version and satisfaction with the trial. Descriptive statistics and content analysis were used to analyze data.

Results:  A total of 1,458 women completed the questionnaire, of whom 86 percent said “yes”—they would participate in the trial again. Themes influencing decisions about participating were perceptions of the external cephalic version experience, preferred mode of delivery, preferred timing of external cephalic version, and perceptions of the effectiveness of external cephalic version and of the trial environment. Many participants preferred the early timing of the procedure offered through the trial because of perceived advantages of a smaller baby being easier to turn and the opportunity for repeat procedures.

Conclusions:  Women were positive about their participation in the trial. Early external cephalic version was preferred over the traditional timing as it was perceived to afford both physiologic and practical advantages. (BIRTH 39:1 March 2012)