Breech birth women 'choice call'

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Pregnant women should be offered an alternative to caesareans if they are facing breech births, experts say.

In the UK, 11% of caesareans are performed due to breech presentation, the Obstetrician and Gynaecologist journal reported.

But experts said women should be offered vaginal delivery or the option of having the baby turned in the womb.

But campaigners said 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.

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

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.

Options

And Basil van Iddekinge, a retired professor of obstetrics and gynaecology at Johannesburg Hospital in South Africa, said women should also be offered the option of vaginal births.

"It seems reasonable to offer women the option of a planned vaginal breech delivery at term, provided strict selection criteria are met, delivery protocols are in place and experienced medical attendants are available for the delivery."

And he added 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.

"The problem is that the consultants often do not have the skills to do this."