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Breech Vaginal Delivery
"Many studies have concluded that the shift to planned cesarean delivery has not improved breech outcomes. Both vaginal and cesarean delivery of a breech baby carries risks. More babies born vaginally will have birth injuries [often due to labour mismanagement] but almost all of them will recover. The same cannot be said for cesarean deliveries where the risk to the mother is much higher, including postpartum infection, a scarred uterus which will increase her risk of uterine rupture and placenta accretia (a condition in which the placenta grows into the uterine wall, causing complications with retained placenta and hemorrhage) in subsequent pregnancies. Though rare, cesarean sections do pose life-threatening risks to mothers and babies. Depending on the individual case, vaginal birth is as much a reasonable, responsible choice as is planned cesarean section."
Who should be eligible for labor?
The ideal vaginal breech presentation is a frank breech position in which baby's buttocks are down and the legs in pike position, hips flexed and knees straight. Frank is the most common type of breech and with the buttocks about the same size as the head, this minimizes the concern that the cervix will not dilate enough and possibly trap the head. Also the umbilical cord prolapsing (coming down ahead of the baby) is greatly reduced.
At the same time, other breech presentations are ideal for breech turning techniques because they tend to turn much more easily than those in the frank breech position.
