The optimal birth position is when the baby’s head is downwards and their face is towards the mother’s back. However, some babies float to a different position before birth and end up with their legs or bottom downwards, towards the birth canal. This is called a breech baby or breech birth—only 4% of babies end up in a breech position.
Most babies do turn to the optimal birth position with their head downwards towards the cervix before the pregnancy term, but a lot of factors could result in a breech position. Doctors usually recommend a C-section over a vaginal delivery for a breech baby. However, the method of delivery is still under scrutiny with a sudden increase in the number of c-sections.
A research published in the ACTA Obstetricia et Gynecologica journal studied 58,320 mothers who had a full-term breech delivery. Though a significant increase (from 24% to 60%) in the planned c-section was observed, the mortality rate of babies lowered from 1.3% to 0.7%.1 The mortality rate in vaginal birth remained close to 1.7%.
This research over the method of delivering breech babies isn’t the only one. In the year 2000, another study with the name Term Breech Trial (TBT) arrived at similar outcomes—they found that the newborn mortality decreased considerably for cesarean delivery as compared vaginal birth in case of a breech baby. However, the study didn’t go unnoticed and brought a surge in the number of c-section deliveries for breech birth—after its successful publication, the number of breech births via c-section increased from 84 to 87% in the US alone.
Yet, another reason came under the spotlight, which might explain the increase in C-section births. Alison G. Cahill, M.D., Chief of the Division of Maternal-Fetal Medicine, Washington University explains that not many doctors—Gynecologists or Obstetricians are practicing vaginal delivery of a breech birth. Though vaginal delivery is medically acceptable and possible in case of breech delivery, doctors prefer a c-section over a normal birth because of two main reasons—they aren’t trained enough in vaginal delivery of breech babies and c-section has become a preferable option over vaginal delivery in today’s medical practice.
Though the research did influence the practice and preference of the delivery of a breech baby in the US, countries like Netherlands haven’t yet adopted the cesarean as a generalized practice in the case of a breech baby, allowing the researchers to collect extensive data for both vaginal and cesarean breech births.
The study results clearly state why cesarean delivery must be preferred over a normal one when your baby is in breech position till the term.
The doctors don’t jump to recommending you a c-section if your baby is in a breech position. With a systematic approach, your medical team will weigh out other options before planning for the surgery.
The first approach is to try an external cephalic version where the position of the fetus is changed by turning the baby from outside the womb. It is performed by a specialist and only after you have crossed 36 weeks into the pregnancy—else, there might be a chance that your baby will twist and turn back to its previous sub-optimal position. Some doctors also recommend waiting, in hope that the baby will spin its way upside down to the optimal position before birth.
Once all the options run out, your doctors will most probably, schedule a c-section. Unplanned or emergency c-sections always carry more risks as compared to planned c-section. Way out your choices—talk to your doctor about them. However, it is highly likely that you will have a c-section if the baby doesn’t flip to the proper position of birth by the term of pregnancy. Here are some ways to encourage your baby’s movement from a breech position to the birth position.
|↑1||Vlemmix, Floortje, Lester Bergenhenegouwen, Jelle M. Schaaf, Sabine Ensing, Ageeth N. Rosman, Anita CJ Ravelli, Joris AM Post et al. “Term breech deliveries in the Netherlands: did the increased cesarean rate affect the neonatal outcome? A population‐based cohort study.” Acta obstetricia et gynecologica Scandinavica 93, no. 9 (2014): 888-896.|