Vaginal Breech Delivery

Vaginal breech birth is more hazardous to the baby than when the baby is born head first. This is largely because the head, which is biggest part, is the last to come out. Special maneuvers are necessary to facilitate the birth, once the baby is out past belly-button level, at which point there is some urgency for the birth process to be completed, as the umbilical cord is being compressed. When the head is stuck, despite the usual maneuvers, special forceps (Piper forceps) may need to be used.

Babies born breech will often be a bit ‘stunned’ at birth and will not be crying vigourously because of the stress of the birth process. Fortunately, this is usually a transient phenomenon, and the on-call Pediatrician will always be in attendance in case resuscitation is required. Babies that have been in a breech position for a long time will often have unstable hips. The Pediatricians will assess for this, and arrange an orthopedic referral when needed. (This also happens when breech babies are born by C-section).

Women deemed to be suitable candidates to try a vaginal breech birth, after the OB has reviewed ultrasound and other criteria, will be given the opportunity if they remain interested after having been fully informed of the risks.

In order to maximize safety, management of the labour will need to adhere to a strict protocol and this will be explained in detail by the OB.

There are some OBs who do not feel comfortable offering vaginal breech birth, based on their level of training and/or lack of experience. There are always two OBs on-duty. If the OB Group doctor on-call does not provide vaginal breech deliveries, the On-Site OB (who manages consultations from midwives and family physicians) may be able to step in. There will be situations where no skilled providers are available, and an emergency C-section will be recommended.