Breech birth

The breech presentation is one of the physiological (normal) foetal positions, allowing for a natural vaginal birth in many cases. However, it has its own specific characteristics compared to a head-first presentation.

In a breech presentation, it is most commonly the baby’s bottom that presses against the birth canal; less commonly, it is the bottom with the legs or the legs alone. Vaginal delivery carries a slightly higher risk for the baby compared to a head-first delivery; therefore, it is advisable to carefully select women for vaginal delivery who meet the criteria for a safe procedure: estimated foetal weight between 2500–3500 g, no scar from previous surgery, foetal presentation as breech or breech with legs, good foetal condition (normal amniotic fluid flow and CTG). Spontaneous onset of labour is ideal, although induction is also possible.  For women who do not meet the criteria for a safe vaginal birth or who do not wish to give birth vaginally, a caesarean section is a good alternative.

If you find yourself in a situation where your baby is presenting in a breech position (or with a part other than the head), we would be happy to see you for a consultation between the 35th and 36th weeks of pregnancy so that we can discuss your delivery options together. In many cases, it is possible to perform an external version to turn the baby into a head-first position; where this is not possible, we will assess your circumstances and plan the approach to your delivery.

A natural breech birth proceeds in many respects in the same way as a head-first birth; free movement is possible during the first stage of labour, as is the option of epidural analgesia, and the use of a steam bath or birthing pool. It is preferable to manage the second stage of labour in the all-fours position, though this depends on the circumstances and the team’s experience. A newborn following a breech birth may experience a slightly prolonged postnatal adaptation period. Breech births are always managed by an experienced birth team, and a paediatrician is always present. 

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