What is the safest way to deliver a breech baby?

A study published in the BJOG has investigated the “safest” way to deliver babies in the breech position.  The research a carried out by conducting a literature review of research on “singleton breech mode of delivery” babies between 1993 and 2014.  This included  27 articles with a total sample size of 258 953 women.  The results that were measured were infant morbidity and mortality from delivery to up to seven days after the birth.

The findings were that the absolute risks of perinatal mortality in planned vaginal and planned caesarean deliveries were about one in 300 and one in 2000 respectively.  So although there is a relatively low absolute risks in either case, planned caesarean deliveries were significantly safer.

Yifru Berhan, Professor of Obstetrics and Gynecology at Hawassa University College of Medicine and Health Sciences, Ethiopia and co-author of the study said:  “Our study substantiates the practice of individualised decision-making around delivering a breech baby. Future research should focus on a comparative study on vaginal breech and non-breech delivery.”

Mervi Jokinen, RCM practice and standards professional advisor said: “The important issue here is that women are aware of the evidence around breech birth, including the risks and the benefits of either a vaginal delivery or caesarean, so that they can make a decision about how they want to give birth. It is important that they discuss this with their midwife or doctor who will offer advice and support.”

Professor Alan Cameron, Vice President of Clinical Quality for the Royal College of Obstetricians and Gynaecologists (RCOG) said: “The Royal College of Obstetricians and Gynaecologists currently recommends that caesarean delivery is the safest mode of delivery for the baby when in a breech position.  However, there are benefits and risks associated with both caesarean delivery and vaginal breech birth and women are encouraged to discuss and weigh up the options with their obstetrician so they can choose the best plan for themselves and their baby.”

Read the full report here

Read RCM response here

RCOG response here