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Amber-Rose Cook and Mum, Leanne just after the birth
Amber-Rose Cook and Mum, Leanne just after the birth

Breech Birth Choice

One in four UK births is by Caesarean section and that is a statistic that many campaigners are unhappy with.

All pregnant women should be offered an alternative to caesareans if their baby is in the breech position. The Obstetrician and Gynaecologist Journal report that in the UK, 11% of caesareans are performed due to breech presentation. Experts say however that women should be offered vaginal delivery or the option of having the baby turned in the womb. Campaigners have been saying for some time that women were often given little choice as there were too few properly trained doctors.

Research has found an elective caesarean for breech delivery at term is often the safest option for most women. But the procedure poses some risks for further pregnancies, including life-threatening problems for mother and baby. One alternative to caesareans is external cephalic version (ECV), involving turning the baby from a breech to a head presentation in the womb at 37 weeks to encourage the baby into a head-first position. This is only recommended if there is immediate access to emergency caesarean as it can cause distress to the foetus. Latest figures show that this is only available in a third of NHS hospitals.
 
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Women should also be offered the option of vaginal births according to Basil van Iddekinge, a retired professor of obstetrics and gynaecology at Johannesburg Hospital in South Africa. He said that it was vital vaginal breech delivery was still taught as it was "inevitable" these deliveries would still occur regardless of whether they were offered or not.

Professor Neil McClure, editor-in-chief of the journal, said: "While we would promote normal birth, there are certain instances where caesarean sections are integral to ensuring a safe birth, and pregnancies where the baby is in a breech presentation is one such example. However, this does not mean that c-sections should always be offered as there are instances where breech delivery or ECV are viable options, provided the maternity unit and doctors have the support they need to help the mother deliver successfully."

Mary Newburn, of the National Childbirth Trust, added: "Women should certainly be offered more choice, but in reality they are not.

July 2007

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