Breech Birth for L&D Nurses

This course helps labor & delivery nurses understand their roles in supporting vaginal breech birth, including normal and abnormal breech birth, maneuvers to resolve abnormal situations, FHR monitoring, room setup, and labor management.

Price

Please inquire for bulk enrollment pricing

$150.00

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Course curriculum

1. How to use this course
2. Breech Without Borders community
3. Media agreement & liability release
4. Pre-course survey
5. Pre-course knowledge assessment
1. Course handouts
2. Louwen 2017: Does upright breech improve outcomes?
3. The Bottom Line On Breech (Midwifery Today 2019)
4. Breech Birth At Home (Fischbein & Freeze 2018)
1. Introduction (Whitney Pinger, CNM MSN FACNM)
2. Introduction (Denny Hartung, MD FACOG)
3. Dr. Emiliano Chavira, MD, MPH, MFM, FACOG
4. Breech Birth Basics
5. It's a foot!
1. The history of breech, the Term Breech Trial, & recent evidence
2. Understanding the evidence, safety, and ethics of vaginal breech birth
3. Why physiological (upright) breech birth?
1. Active mother, mobile pelvis
2. Know the mechanisms
3. Inside & outside
4. Disimpact & rotate
5. Birth stools
6. Introduction to the 10 steps of normal (and the 10 deviations) of breech birth
7. Step 1: Baby rumps sacrum transverse (ST) or oblique (SO)
8. Step 2: Baby descends and rotates to sacrum anterior (SA)
9. Step 3: Legs release spontaneously
10. Step 4: Chest crease = arms are not stuck
11. Step 5: Tummy crunches
12. Step 6: Arms release spontaneously
13. Step 7: Full perineum = head is well-flexed
14. Step 8: Head releases spontaneously
15. Step 9: Baby passed to the mother
16. Step 10: Cord remains intact
17. Video examples of normal breech births
18. Wait for the next contraction?
19. Normal Breech Birth Recap
1. Dr. David Coggin-Carr, OBGYN, MFM
1. Counseling and Informed Consent (Denny Hartung, MD)
2. Risk counseling (David Coggin-Carr, MD)
1. The Maternity Environment and Birth Physiology (Sarah Buckley, MD)
2. Birth in the labor room, not the OR (Denny Hartung, MD)
3. Preparing the Birth Room
4. Breech Cart
1. FHR Interpretation
2. EFM Interpretation (David Coggin-Carr, MD)
3. FHR Monitoring (Denny Hartung, MD)
4. Where to place the monitor lead (Joanna Ranelli, RN CNM)
5. Fetal monitor tracing example - acute cord compression
6. Assessing fetal well-being during expulsion
7. How to distinguish between tummy crunches and fetal gasping
1. Dr. Amber Warmsley, OBGYN
1. Nurses' roles during the birth (Becky Walker, CNM)
2. Breech labor
3. Pain management (Denny Hartung, MD)
4. Induction (Denny Hartung, MD)
5. Positions for labor & pushing (Denny Hartung, MD)
6. Pushing & expulsion
7. Second Stage and Calling a Time Out Prior to Rumping
8. How and When to Push
9. Having a Timekeeper For Rumping & Birth
10. Delayed Cord Clamping and Preparing for Resuscitation
11. Whitney Debriefing
1. Joanna Ranelli, CNM & L&D Nurse at GWU
1. Introduction
2. Decision tree for when to assist
3. The Most Common Maneuvers & The Importance of Maternal Movement
4. Obtaining consent for maneuvers
5. Introduction and maternal movement & positioning
6. Tips for L&D nurses: Maternal movement & positioning
7. Essential Maneuver #1: Shoulder/chest press
8. Essential Maneuver #2: Crowning Touch
9. Essential Maneuver #3: Ritgen
10. Tips for L&D nurses: Birthing the head
11. Essential Maneuver #4: Side to Side
12. Essential Maneuver #5: Arm sweeps
13. Tips for L&D nurses: Raised or nuchal arms
14. Example 5.1: Anterior arm release
15. Essential Maneuver #6: Fundal pressure
16. Example 6.1: Fundal/suprapubic pressure
17. Tips for L&D nurses: Fundal pressure
18. Essential Maneuver #7: Hyperextended head in the pelvic inlet (rare)
19. Are there other ways to resolve a hyperextended head in the pelvic inlet?
20. Tips for L&D nurses: Assisting with a hyperextended head in the pevlic inlet
21. Soft tissue maneuvers
22. Example of chest press + gluteal lift
23. Tips for L&D nurses: Soft tissue maneuvers
24. Perineal integrity & episiotomy
1. Introduction
2. Introduction to supine/birth stool maneuvers and hand placement
3. Assisting the legs
4. Freeing the arms (Løvset Maneuver)
5. Releasing the head
1. A neonatologist's perspective on breech
1. Suggestions for home-to-hospital transfers
1. Wrapup and Pearls for Breech Birth
1. Please add your tips & practical advice to this course
1. Post-course evaluation
2. Post-course knowledge assessment
3. Course review

About this course

$150.00
99 lessons
4.5 hours of video content

Breech Birth for L&D Nurses

Price

$150.00

Course curriculum

Getting started

Course handouts and articles of interest

Introduction to breech

What does the evidence say?

Understanding normal breech birth

Provider perspectives: Dr. David Coggin-Carr, OBGYN MFM

Counseling and Informed Consent

Room setup

Assessing fetal wellbeing

Provider perspectives: Dr. Amber Warmsley, OBGYN

Labor & Birth

Provider Perspectives: Joanna Ranelli, CNM & L&D Nurse at GWU

Maneuvers for abnormal breech birth

Supine or birth stool maneuvers

Provider Perspectives: Dr. Jonathan Cohen, Neonatologist

Suggestions for hospital transfers

Conclusion

Wisdom from our community of learners

Evaluations

About this course