What is a Breech Birth

At the time of birth, a baby may be in any one of several positions.  Fortunately in most deliveries, the baby’s head passes through the birth canal first.  Because the head is round and firm, it serves more effectively to stretch the mother’s pelvic organs than would some other part of the baby’s body.  With respect to the mother, the baby’s face may be directed either backward or forward; delivery is easier in the former position.

In some cases of delivery, the baby’s buttocks pass first through the birth canal.  The term used for such an instance of delivery is “breech birth” (or “breech presentation”).  In a breech birth, labor is more difficult; rather than allow the longer, more difficult breech delivery, an obstetrician may recommend a cesarean operation.  Still in other few cases of delivery, the shoulder or some other part of the baby’s body is positioned across the birth canal when labor begins.  In such a case, the obstetrician must choose between internally manipulating the baby’s body and performing a cesarean operation.

A breech birth may happen early in pregnancy, when the fetus is small and there is an extent of space for it to move about.  As the delivery date nears, most babies line their bodies up in the mother’s womb in a way that they come out during delivery headfirst.  For some reasons, about 3 to 4 percent of babies do not move into a headfirst position.

Most obstetricians will recommend a cesarean delivery if it happens that a breech baby is also the mother’s first pregnancy.  A vaginal delivery may be possible in subsequent pregnancies in case the baby is in an extended breech position.  In this position, the baby’s legs are extended so that her/his feet are at ear level and her/his head bent towards the knees, as in a jackknife position.

But if the baby is in a more difficult position, the obstetrician will most likely insist on a cesarean operation.  The reason for this is that during the vaginal delivery of a breech baby many complications can take place.  Note that obstetricians do not always recommend vaginal delivery even in the case when a baby is in an extended breech position.  The decision to proceed with vaginal delivery depends on three considerations:  the position of the head of the baby, the size of the pelvis of the mother, and the weight of the baby.

A breech birth is the one instance in the medical field of obstetrics in which X-rays are necessary.  This is because X-rays provide factual information needed to determine whether or not to go ahead with vaginal delivery.  At a point in the course of the delivery, an episiotomy (surgical incision of the perineum to enlarge the vaginal opening) may have to be performed to make easier the coming out of the baby.

Sources:

1. “Breech Presentation” by Richard Fischer, MD, Co-Division Head, Maternal-Fetal Medicine, Professor, Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Cooper University Hospital – http://www.emedicine.com/med/topic3272.htm

2. Women Fitness – http://www.womenfitness.net/preg_breech_presentation.htm