Studies show that breech babies have a lower risk of birth injury and newborn complications if delivered surgically rather than vaginally. The main concern in the vaginal delivery of a breech newborn is that, with the feet or buttocks presenting first, the head will not have enough time to mold itself to the pelvic canal and may get stuck once the rest of the body is out. Also, a breech delivery can cause damage to the major nerves leading to the arms and hands. Both of these complications are less likely when baby presents buttocks first rather than feet first (frank breech). Prolapse of the umbilical cord (the cord slips through the cervix before baby’s body and gets pinched), an emergency requiring an immediate cesarean delivery, is more common in all breech deliveries. Baby’s being in the breech position does not mean you absolutely must have a cesarean birth.
The American College of Obstetricians and Gynecologists officially sanctions vaginal births for breech babies as safe in selective situations. Your doctor will weigh the risks of the surgical versus the vaginal birth and recommend the course of action that is best in your situation.
Here are some of the alternatives to explore with your doctor that may make it possible to deliver your breech baby vaginally:
- Consider the possibility that your baby might turn. Around half of all babies start out bottom down early in pregnancy. Most turn head-down by 32-34 weeks. For some unknown reason, three to four percent of babies never turn head- down.
- If your baby hasn’t turned on her own by 36-37 weeks, your doctor (or a specialist you are referred to) can attempt a maneuver called external version, in which he or she manipulates your abdomen to turn baby into the head-down position. External version is successful 60 to 70 percent of the time (40-50 percent for first pregnancies), but some babies turn back and require a second attempt.
- Search out a doctor who has experience in vaginal delivery of breech babies. He or she will most likely be affiliated with a hospital that has the technology and support staff to properly care for the baby should a complication occur. Obstetricians and hospital centers with a lot of experience in vaginal breech deliveries usually follow the American College of Obstetricians and Gynecologists Guidelines for breech delivery.