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. She is currently supervising a further evaluation of the training package, carried out in nine NHS Trusts in England and Northern Ireland, including before/after perinatal morbidity and mortality data.
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 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. Shawn's research and this year the algorithm, has been the backbone of two breech two-day conferences in Denmark, each attended by over 130 obstetricians and midwives from each maternity unit in Denmark and across Europe. The unit hosting the conferences (Hospital of Southern Denmark) has successfully implemented PBB, and currently 85% of eligible women are choosing this option.
Shawn is supervising two further breech-related projects. One is assessing the theoretical demand for vaginal breech birth in St. George’s Hospital, London. The other concerns priorities for student midwifery training in breech delivery. She is also leading a team of student, clinical and academic researchers looking at how we teach midwives about sexual and gender diversity among maternity care clients, using focus groups and content analysis.
Shawn also works clinically in two clinical sessions per week at St Thomas' Hospital as a Consultant Breech Specialist Midwife. Her role as a Consultant Breech Specialist Midwife is to co-ordinate the ECV clinics, and to provide hands-on breech training for clinical staff, working alongside obstetric colleagues.