Resources for parents and providers

Determining Your Birth Path

When you are faced with making the decision about how to birth your breech baby, whether vaginally or cesarean, it can be overwhelming and frustrating.  Here are pros and cons for both modes (vaginal and cesarean) as well as various questions to ask yourself when planning your birth.

 

Vaginal Breech Birth (VBB):

  • Breech is unusual, not abnormal.
  • There have been widely quoted studies which found no difference between breech infants delivered vaginally and breech infants delivered by caesarean.¹,6
  • Babies will benefit from experiencing labor, better preparing them to breathe as well as promote hormones that help them adapt to life outside the womb.4
  • Babies will benefit from exposure to mother’s microbiota, setting a foundation for their immune system.5
  • Compared with cesarean, there is less blood loss, less risk of injury and infection, no complications associated with surgery, and shorter hospital stay.³
  • Rates of cord prolapse increase with footling and complete breech.¹
  • Potentially requires assistance from your care provider to actively help manoeuvre your baby out of the pelvis. This may include the use of forceps.³
  • If you attempt giving birth vaginally and are not successful, you will require a cesarean birth. Compared to a planned cesarean birth – where the decision to have a cesarean is made ahead of time and scheduled before your due date – an unplanned cesarean birth carries greater risks for mother and baby.³

Cesarean Birth:

  • In some settings and in some situations (e.g., placenta previa and other complicating pregnancy factors), cesarean birth may outweigh the risk of vaginal breech birth.
  • Breech presenting babies are still born bottom first even when delivered operatively.¹
  • Widespread use of caesarean delivery for breech babies has not demonstrated an improvement in the outcome statistics.¹
  • All breech babies are at risk for fetal hemorrhage, lacerations, fractures, nerve injuries, and head entrapment.  Cesarean-born babies have a greater risk than vaginally-born babies for infection and respiratory distress.²
  • An additional disadvantage to an elective caesarean section prior to onset of labor is that the baby does not benefit from experiencing labor contractions.¹
  • Going into labor prior to cesarean is an option.

 

 


1 Breech PresentationCaesarean operation versus normal birth.
Lowdon, G.
AIMS Journal Autumn 1998, Vol 10 No 3.
http://www.aims.org.uk/Journal/Vol10No3/breechCSvsNormal.htm
2 http://www.mybreechbaby.org/vaginal-breech-birth.html
3 http://www.powertopush.ca/birth-options/types-of-birth/if-your-baby-is-breech/vaginal-breech-birth/
4 http://www.mypregnancymatters.co.uk/known-breech/4577619664
5 http://midwifethinking.com/2014/01/15/the-human-microbiome-considerations-for-pregnancy-birth-and-early-mothering/
6 Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium.
Goffinet F, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, Bréart G; PREMODA Study Group
Am J Obstet Gynecol. 2006 Apr;194(4):1002-11.
http://www.ncbi.nlm.nih.gov/pubmed/16580289