Attitudes of maternity care providers toward regional centralisation of vaginal breech birth: a qualitative study

OBJECTIVES: To explore maternity care providers' attitudes toward regional centralisation of vaginal breech birth (VBB) care and gather their recommendations for maintaining clinical proficiency. DESIGN: Exploratory qualitative study using semi-structured interviews and thematic analysis. PARTICIPANTS: 10 hospital-based maternity care professionals (nine obstetricians and one clinical midwife), purposively sampled to represent experience and institutional diversity. SETTING: 10 hospital maternity units in a metropolitan region of the Netherlands.Key themes describing provider attitudes towards two proposed models of centralised care (mobile breech team, designated referral centre) and alternative strategies. RESULTS: Three core themes emerged: (1) proficiency-providers valued regular exposure, formal training and peer support, expressing concern that centralisation would reduce overall workforce readiness; (2) organisation-concerns included unequal access, staffing burden, legal risks and inefficiencies in mobile teams and (3) alternatives-participants preferred a regional breech network with shared training, joint video review and expert on-call support. CONCLUSIONS: Maternity care providers opposed full centralisation of VBB, favouring a networked model that distributes expertise and preserves local access. These insights highlight the importance of involving frontline providers in service redesign. TRIAL REGISTRATION NUMBER: Not applicable.