Breech presentation at term complicates 3–4% of pregnancies and is associated with increased cesarean delivery rates. National guidance recommends offering external cephalic version (ECV) to all eligible women, with an expected success rate of approximately 50%. This audit was conducted to evaluate ECV practice at Kettering General Hospital (KGH) and its cost-effectiveness. We retrospectively reviewed cases of term breech presentation between April 2023 and September 2024. Data were collected on eligibility, documentation of counselling, acceptance or decline of ECV, outcomes of attempted ECV, and subsequent mode of delivery. National guidance and previous audit data were used for benchmarking. Of patients identified with term breech presentation, 77% were offered ECV, while 23% were not, primarily due to contraindications. Counselling documentation and provision of ECV information leaflets were variable. Among those offered ECV (n=73), 58% declined and 42% accepted. A total of 30 ECVs were performed, with a success rate of 43.3% (13/30). All women with successful ECV delivered cephalically. Unsuccessful ECVs (56.6%) frequently occurred in cases of extended breech or undocumented breech type. Cost analysis demonstrated significant savings: with ECV costing £512 per attempt, each successful ECV avoided a cesarean delivery, saving £3288 per patient, equating to £21,372 across 13 successful cases. This audit demonstrates ECV uptake and success rates at KGH comparable to national figures. Improving counselling, consistent documentation, and provision of patient information leaflets may enhance acceptance rates. ECV remains a clinically effective and cost-saving intervention in reducing cesarean births associated with term breech presentation

Dr. Ayisha Bhutta is an experienced Obstetrician and Gynecologist with over 10 years of clinical experience. She holds an MBBS, MRCPi (ObGyn), and MRCOG Part 1, and continues to enhance her expertise through continuous professional development and workshops. She has extensive experience in antenatal, gynecology, labor ward, emergency, and operative care, and currently works at Latifa Women and Children Hospital. Dr. Bhutta is actively involved in teaching medical students and mentoring junior doctors, reflecting her strong passion for education, mentorship, and advancing women’s health. Her clinical strengths include managing high-risk pregnancies, making swift and accurate clinical decisions under pressure, and delivering compassionate, patient-centered care. Dedicated to continuous learning and professional growth, Dr. Ayisha Bhutta remains committed to achieving excellence in Obstetrics and Gynecology within the NHS.