We want to find out if midwives can accurately identify a baby’s position before it is born using a small handheld ultrasound device.

What we already know:

During late pregnancy checks, midwives feel a woman/birthing person’s* tummy using their hands (abdominal palpation) to check the baby’s position, but up to 40% of breech (bottom down) babies are missed by palpation alone.

Knowing the baby’s position is particularly important so that a safe birth plan can be made

• Breech babies are at higher risk of complications during normal birth than cephalic (head down) babies

• Emergency breech births are riskier for baby and mother, so knowing which way the baby is positioned is important to provide the information needed to make an informed choice about care

An alternative and more accurate way to check the baby’s position is by using ultrasound. Conventional ultrasound scans are usually undertaken in a hospital by specialist sonographers (healthcare professionals who specialise in doing ultrasound scans) and doctors, and require a large room and air conditioning.

Point of Care ultrasound (PoCUS) with handheld devices has become popular in some areas of medicine. This new technology is small, portable, and quick to use in any setting.

What we want to find out

To work out whether PoCUS scans to check a baby’s position should be part of routine pregnancy care in the NHS, we need to be sure that they are accurate, cost effective, and acceptable to patients and midwives. To do this we will:

• Compare the findings from PoCUS scans to ‘gold standard’ conventional ultrasound scans

• Carry out interviews and focus groups to find out what people think of PoCUS scans

• Use health records and questionnaires to work out whether it will save money for the NHS

* Within this information we may use the terms ‘woman’ and ‘women’. However, we know that it is not only people who identify as women who may want to access this information about their choices around birth. Your care should be appropriate, inclusive and sensitive to your needs whatever your gender identity.