Exciting news for women that would like to have a vaginal delivery and have been told that they must have a C-section if the baby is breech. More research is demonstrating that a vaginal breech birth has about the same risks as a C-section, with a better impact on maternal health overall.
While there are several types of breech presentation, not all are considered to be of equally high risk. Doctors need to weigh each situation by it’s own merits, rather than using a ‘one operation fits all’ approach. The ‘term breech trial’* done in the late ’90’s, pushed maternal vaginal birth choices aside. The study made Caesarean births seem like the only safe option. This study proved seriously flawed, but follow up studies were largely ignored–Caesarean births were the front-line option of choice for many doctors who wanted a faster, standardized birthing process.**
“Cesarean section, explains Prof. Glezerman, is not just another method of delivery. A major surgical procedure, a C-section is not only riskier for a woman and decreases chances she will be able to breastfeed, it also increases maternal risks in future pregnancies.”
A great concern, however, is that many delivery doctors are not trained to actually deliver breech babies at all! “The skill has disappeared,” Glezerman explains. “Residents are no longer taught these techniques, and senior physicians are doing it less and less. We need to go back to the future and relearn what has been forgotten.”^
Dr. Krause, director of the Nurnberg perinatal unit, states that after examining 1500 breech births “vaginal delivery is safer than planned cesarean section and does not lead to higher perinatal mortality or neonatal morbidity. ..The excess surgical intervention [of cesarean] without neonatal benefit was unjustifiable.”**
*Hannah ME et al (2000). Planned cesarean section versus planned vaginal birht for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet, 356:1375-83.