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So Breech Babies Have To Be Delivered By Cesarean?

Katlyn Joy |19, August 2014


Too many breech babies are still being born vaginally, says new study. The study out of the Netherlands, found that while vaginal births of breech babies has dropped since a landmark study came out in 2000 advising c-sections for breech babies, 40 percent of mothers still opt for vaginal births for their breech babies today.

According to the latest data in the new study, which covered all full term singleton births in the country between 1999 and 2007, of 1.4 million births, 60,000 were breech. That adds up to about 4 percent.

In 2007, 60 percent of women who found they were carrying a baby in the breech position planned a cesarean birth, compared to 24 percent in 1999.

In 2000, a study came out of the Netherlands finding that there was a 33 percent higher risk of death or injury with a vaginal versus c-section birth in breech babies. This study led to reduced vaginal births of babies with abnormal birth presentations, worldwide.

What are the Types of Breech Presentations

The ideal birthing position is when baby is turned headfirst in the birth canal, since the head is the largest part of the baby and once the head emerges, the rest of the body should easily slip out.

In a frank breech presentation, the baby presents butt-first, with legs stretched up straight towards the baby's head. It is also the most common of the breech presentations.

In a complete breech, baby is in a cross-legged sitting position, with the buttocks and feet nearest the birth canal.

In the transverse lie, the baby is lying horizontally as if in a hammock. The baby could be back up or back down. Most babies turn out of this position before birth, but some remain in this impossible position.

Risks of Vaginal Birth for Breech Babies

Breech babies are more likely to be injured during birth. They are more likely to develop a birth defect of the hip socket and thigh bone becoming separated. The umbilical cord can become compressed during delivery, cutting off blood flow and oxygen to the baby. Breech babies born vaginally can suffer from broken bones and bleeding, and of course, they sometimes die.

Seven babies in 10,000 die from planned cesareans. However, of every 339 cesareans due to breech presentation, one baby's life was saved. The risks are generally higher with vaginal birth of breech babies than the risks associated with c-sections. However, individual cases must be evaluated independently by a physician to make the best choice for each patient and baby.

Since the 2000 study, the death rate from the planned vaginal births of breech babies has stayed constant at about 17 babies out of 10,000.

If it is known that baby is in a breech position before labor, a doctor may give a woman some exercises to try and urge baby into the proper position. Sometimes a procedure known as external cephalic version is tried. It is done in a hospital setting and the baby will be checked out to see if the heart rate is good. The doctor will attempt to move the baby into the correct position. An anesthesiologist will be on hand to do an emergency cesarean if indicated. On average, cephalic version is successful about 60 percent of the time, according to the American Academy of Family Physicians.

Some women want to try to do a vaginal birth because they want to have more children and are concerned about risks from multiple cesareans.

While most breech births have happy outcomes, the risks are there and must be considered when planning for the birth. Breech births are particularly dangerous when they occur outside of a hospital setting, since a midwife could not perform an immediate c-section when indicated, such as when a baby becomes stuck in the birth canal or the umbilical cord slipped out ahead of the baby through the birth canal.

If your doctor finds your baby is not in the proper position as your delivery date draws near, you will be checked regularly to see if baby has turned. The doctor may use a combination of manual checks as well as ultrasounds to determine baby's position.

Related Articles

Guide to Cesarean Sections

Safety of Vaginal Birth After Cesarean

Vaginal Delivery After Cesarean (VBAC)

Create a Positive Cesarean Birthing Experience

New Study Links Cesarean Sections to Endometriosis


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