Attitudes of maternity care providers toward regional centralisation of vaginal breech birth: a qualitative study.

Abstract

To explore maternity care providers' attitudes toward regional centralisation of vaginal breech birth (VBB) care and gather their recommendations for maintaining clinical proficiency. Exploratory qualitative study using semi-structured interviews and thematic analysis. 10 hospital-based maternity care professionals (nine obstetricians and one clinical midwife), purposively sampled to represent experience and institutional diversity. 10 hospital maternity units in a metropolitan region of the Netherlands.Key themes describing provider attitudes towards two proposed models of centralised care (mobile breech team, designated referral centre) and alternative strategies. Three core themes emerged: (1) proficiency-providers valued regular exposure, formal training and peer support, expressing concern that centralisation would reduce overall workforce readiness; (2) organisation-concerns included unequal access, staffing burden, legal risks and inefficiencies in mobile teams and (3) alternatives-participants preferred a regional breech network with shared training, joint video review and expert on-call support. Maternity care providers opposed full centralisation of VBB, favouring a networked model that distributes expertise and preserves local access. These insights highlight the importance of involving frontline providers in service redesign. Not applicable.