Recent Washington Post Article on Breech

Today in the Washington Post there was an article about the safety and prevalence of vaginal breech births. Breech is a common reason for primary cesarean sections; something that some mothers and obstetricians are beginning to question. In the article it talks about a flawed study in 2000 that resulted in the thought that across the board cesarean section was indicated for all breech presentations. However since then this article has been questioned as many of the providers who performed the breech extractions/births were not skilled enough in breech birth to attend the women. This provided the authors of the study with inadequate data regarding the true safety of breech.

Recently in Canada the breech protocols were changed and doctors were encouraged to support vaginal breech deliveries under a limited set of criteria. This is promising as vaginal delivery of a breech baby would limit the need for many primary and secondary cesareans. Of course, fear of litigation is a driving factor as not all breech births (or births in general) have a necessarily desired outcome. But that should not limit the ability of other mothers to try. True, individualized care is what is appropriate for women, not fear-based protocols.

And also accepting that not every breech presentation is appropriate for vaginal delivery is another important factor to changing the mindset. It is almost universally accepted that footling breech and transverse presentations are not a good candidate for vaginal birth. That is not to say women have not successfully delivered this way, it is just not optimum for success. For more information about breech and breech vaginal deliveries please click here for the ICAN article on breech.