Breech Without Borders Trains Midwives and Doctors in Anabah

At the Anabah Maternity Centre, EMERGENCY and Breech Without Borders are working together to improve health outcomes for mothers and babies.

What is breech birth?

Breech birth is a broad term used when an infant in utero has its feet, knees or bottom facing the birth canal, rather than its head. These positions are associated with a higher risk of complications for babies, as the process of birth is more complex and is more likely to require intervention. About 4% of babies are born breech when carried to term, and the rate is even higher for babies born early.

In many countries with advanced medical systems, a breech baby is often delivered via caesarean. However, caesarean sections are associated with their own risks for both the mother and child, and can have an impact on the mother’s future pregnancies and births. In low-resource settings, costly caesarean sections and any future complications may also burden already weakened healthcare systems.

Breech Without Borders is a non-profit that provides training, resources and educational materials to medical professionals around the world on the best practices for vaginal breech birth.

These new practices are changing a lot of things for us: babies are healthier and mothers are happy to be so active during the birth.”

Khatera, Obstetrician at Anabah Maternity Centre

Breech Without Borders at the Anabah Maternity Centre

In Anabah, Afghanistan, EMERGENCY’s Maternity Centre has served women in the Panjshir valley and neighbouring regions since 2003. The hospital was expanded in 2016, and today is staffed by more than 150 Afghan women.

Since September 2024, Breech Without Borders has been collaborating with EMERGENCY to train midwives and physicians in Anabah, where around 27 breech babies are delivered every month.

We find this new approach to breech birth very interesting and effective. One really positive aspect is that the mother is free to move and is active during the birth: we explain to her that the birth will be in an upright position and that she can move around as much as she needs,” says Rowzia, Midwife at the Anabah Maternity Centre.

“We have noticed that the outcomes for both mothers and babies are better, and babies can stay more skin-to-skin with the mother. It’s not an easy process to change the standard practice from a supine to an upright maternal position, but the good teamwork and the positive outcomes that we have seen make us happy to try to improve every day.”

More than 30 staff members at the Maternity Centre have participated in breech training sessions so far. 

The course is really well explained, and we have found it both challenging and effective to work together as a team of midwives and doctors,” says Khatera, Obstetrician at the Anabah Maternity Centre.

“Before, we used to see more complications in breech births, which made us less confident in assisting them. Now, the team is happy to assist with upright breech births. It is a new technique that requires a lot of practice, but we see the good results and this makes us enthusiastic.”