Breech presentation

If a baby is breech, it means that the baby is the wrong way around with his bottom down and his head up. You are likely to only find out late in pregnancy that your baby is breech. Most babies however turn around before being born, leaving around 1% of babies in the breech position at onset of labour.

Most hospitals in the UK have the policy to deliver breech babies via elective caesarean section at 38 weeks. Unfortunately most mothers are not given much choice in the matter.
It is possible though to deliver a breech baby via a vaginal birth and there is no evidence that having a caesarean section would be better and safer for baby and mother. A caesarean section is a major abdominal surgery and does not come without risk for both mother and baby.

Should the mother choose to have a vaginal birth, it is unlikely that she will find much support. In a hospital setting she will very likely be strapped to the bed with her feet in stirrups. The baby will be monitored continuously and will be delivered via forceps. (Which means a large episiotomy to accommodate the forceps). Should this scenario not work a caesarean section be performed after all. With this picture in mind it is not surprising that many women think their only option is a caesarean section. What is the point of going through labour only to end up in theatre anyway?

Of course there is the option as well of an active vaginal birth. This means that the mother will squat or stand up to deliver the baby. The big advantage of this is that you can move freely what is beneficial in labour. It will speed up the labour and is likely to make it more comfortable for the mother.
This option however will not win much support in a hospital surrounding. It is very likely that the midwives and doctors will ‘advise’ you to lay down on the bed and have an assisted delivery, i.e. the use of forceps. There are less and less women that have a vaginal birth with a breech baby and therefore there are less and less midwives and doctors that are trained in an active vaginal breech birth. You will have to be very strong minded to have an active breech birth in hospital. Don’t be surprised if pressure is put on by saying that it is dangerous to have an active birth and that you will need to lay down to deliver the baby safely.

Midwifes will tell you for sure that you can not have a home birth if your baby is breech. This might be advisable as midwifes tend to be less trained in breech vaginal delivery.
There are however independent midwives that are trained and experienced in vaginal active breech births and have assisted women in breech home births. You can find a list of independent midwives at www.independentmidwives.org.uk.

Even though breech babies have higher risk of mortality, having a caesarean has not proven to be any safer than a vaginal birth for breech babies.

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Breech babies