Dr Shawn Walker

Shawn is a clinical academic midwife, currently funded by an NIHR Advanced Fellowship (2020-2023), to undertake feasibility work for a trial of vaginal breech birth at term, using a physiological breech birth approach. Her research focuses on how to improve the safety of vaginal breech birth.

Shawn has worked in all midwifery settings - home, freestanding and alongside midwifery units and obstetric units. Her PhD research arose out of advocacy work with service users, seeking to improve the care pathway for women with breech-presenting babies and working closely with my obstetric, anaesthetic and neonatal colleagues to do this. It focused on the question: How can clinicians learn to safely deliver breech babies in the current maternity care context, given minimal opportunities to attend breech births?

From 2012-2014, Shawn pioneered the clinical role of Breech Specialist Midwife at James Paget University Hospital NHS Foundation Trust, a small unit with 2000 births per year in Norfolk. Approximately 1:20 women who used this service transferred in from other hospitals due to unmet demand elsewhere.

Out of her research, Shawn developed and evaluated a physiological breech birth (PBB) training programme that is now delivered to over 2000 health care professionals globally each year through a not-for-profit company, of which she is the Director, Breech Birth Network CIC (breechbirth.org.uk). In addition to at least 20 NHS Trusts and Ambulance Services who use her evidence-based teaching materials in mandatory training, her publications on PBB methods are referenced as key sources in midwifery breech training programmes in Canada and the Netherlands. This training programme is the only vaginal breech birth training programme to have published associated outcome data and to have demonstrated a significant behavioural change post-training.

Other projects include a detailed time-to-event video analysis project using 42 films of upright breech births, to further inform timelines of what is considered ‘safe’ in a vaginal breech birth (Reitter and Walker, 2019). This project informed the development of a decision-making algorithm of manoeuvres and timings already transforming practice in obstetric units where PBB is practised, in the UK, North America and Europe. This algorithm is currently being evaluated for its value in predicting adverse outcomes in a case-control study.

Shawn also works clinically as an Honorary Consultant Midwife at Chelsea and Westminster Hospitals NHS Foundation Trust, where she supports the breech care pathway.