Acceptability and Feasibility of External Cephalic Version Among Patients and Clinicians in Ghana [ID 944]

INTRODUCTION: Avoidable cesarean deliveries (CDs) have associated morbidity and mortality. External cephalic version (ECV) is a low-risk, cost-effective procedure to reduce avoidable CDs. In low- and middle-income countries, ECVs are not commonly performed. Our aim is to determine the acceptability and feasibility of external cephalic version among Ghanaian patients and clinicians. METHODS: We are conducting a prospective cohort study of patients presenting with malpresentation and their respective clinicians at an urban, teaching hospital in Accra, Ghana, from July 2024. Patients were followed up from 36 weeks of gestation to delivery. After delivery, patients and clinicians completed a semistructured interview regarding their malpresentation experience and management, respectively. We are analyzing data via sequential explanatory mixed methods. RESULTS: About 14 (58%) eligible patients were offered ECV, and 3 (21%) patients declined. The success rate of ECV is 36%. For patients who had an ECV whether successful or not, they appreciated the ability to try to avoid a CD. For patients declining ECV, this was influenced by their partner. All patients not offered ECV expressed that if given the opportunity, they would try an ECV to avoid a CD. All clinicians understood the importance of offering ECV to reduce avoidable CDs, and those who did not offer ECV took a conservative approach to the patient’s potential ECV success. CONCLUSIONS/IMPLICATIONS: Patients and clinicians understand the importance of reducing avoidable CDs and accept the role of ECV in achieving that goal. Including patients’ partners in counseling and further clinician training for ECV can help to increase the feasibility of ECV.