Breech childbirth

What is breech childbirth?

At the time of labour, most babies are positioned head down in the uterus. Sometimes, however, a baby will be positioned so that the feet or bottom will come out first during childbirth. There is usually no obvious reason why a baby does this. Some possibilities include:

• Preterm birth (before 37 weeks)
• Too much or too little amniotic fluid
• Multiple birth (twins, triplets etc.)
• The length of the umbilical cord
• The size or shape of the uterus or uterine abnormalities

There are three possible breech positions:

Can a baby in the breech position be turned?

If your baby is breech and you are at about 36 weeks pregnant, your health care provider may attempt an ‘external version’ where he or she will attempt to rotate the baby from outside. This works about half the time and if it does then it is possible to have labour and delivery just as if the baby had been head down all along. To have the greatest chance of success, this maneuver should be attempted between 35 and 36 weeks gestation.

If my baby is breech can I still deliver naturally?

In Canada, it has been the norm for most breech babies to be delivered by a Caesarean section. However, today, more women are delivering breech babies vaginally. Vaginal deliveries involve faster recovery and less pain than C-sections and so are preferred when possible because of research demonstrating greater safety for the baby. There are specific risks for breech babies. Their head,which is the biggest part, comes last and can become trapped. The choice of the right approach to delivery in a breech is one that takes all the risks and benefits in your particular circumstances into account.

To attempt a vaginal breech delivery, you will need a health care provider with expertise in breech delivery and also a normal pregnancy:

• Full-term pregnancy (37-40 weeks)
• The baby is a healthy, correct weight (neither small nor large)
• The baby is in a complete or frank breech position
• You and the baby are healthy

If these conditions are not met, or if labour is not progressing normally, or the umbilical cord comes out before the baby, C-section is the safest delivery option. A C-section is also performed if the baby is in the footling breech position.