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  • Title: Experience and confidence in vaginal breech and twin deliveries among obstetric trainees and new specialists in Australia and New Zealand.
    Author: Yeoh SGJ, Rolnik DL, Regan JA, Lee PYA.
    Journal: Aust N Z J Obstet Gynaecol; 2019 Aug; 59(4):545-549. PubMed ID: 30565217.
    Abstract:
    BACKGROUND: The number of vaginal breech and twin deliveries may be insufficient for adequate training. OBJECTIVE: To determine whether advanced trainees and new Fellows in obstetrics are gaining adequate experience and confidence in vaginal breech and twin deliveries. METHODS: An online survey was emailed to registered Royal Australia and New Zealand College of Obstetrics and Gynaecology (RANZCOG) advanced trainees and new Fellows (Years 1-5). This survey asked about their experience, confidence and whether they intend to perform vaginal breech and twin deliveries as specialists. RESULTS: The survey was sent to 703 advanced trainees (162) and Fellows (541) and answered by 217 (31.7%). Experience and confidence in vaginal breech and twin deliveries increased with the number of procedures performed (P < 0.001) in both groups and were significantly higher among Fellows. Despite the level of experience, 100% of respondents felt confident in managing vaginal twin deliveries with or without supervision, whereas 14.9% of respondents did not feel confident in managing vaginal breech deliveries. Intention to offer these procedures in their practice depended on confidence levels, and there was a significant difference between twins and breech. Overall, 87.3% of respondents intended to offer vaginal twin deliveries in their practice, while only 32.7% intended to offer vaginal breech deliveries. CONCLUSION: Confidence in complex vaginal deliveries increases with increasing number of procedures performed and a significant proportion of trainees and Fellows consider they do not have sufficient experience. The association between confidence and intention to offer these procedures is stronger in twins than in breech deliveries.
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