Women with breech babies may be forced into having caesareans because of a shortage of doctors experienced in bottom-first births at Victoria's public hospitals.
This comes amid controversy over the closure of the state's only specialist breech clinic, at the Royal Women's Hospital, with fears about the risks of breech births reportedly behind a decision not to advertise for a replacement clinician.
Women who recently visited the hospital with a baby in a breech position said they were told the hospital no longer did planned vaginal breech births.
Another said she was booked in for a caesarean "without any mention of the option of a vaginal birth".
The Royal Women's Hospital has confirmed staff with vaginal breech expertise were diminishing, but said the breech clinic had not been shut down but instead incorporated into its existing pregnancy clinic.
Current and former patients of the Royal Women's Hospital have called for management to train more staff in vaginal breech births.
"I can't understand why if they're saying this generation of doctors is unskilled, why are we not upskilling them?" said Renee Wijesinghe, who gave birth with the hospital's breech clinic earlier this year.
"We upskill in all other fields of our work as medicine develops, so why is it any different? It's not like breech births are new."
Mrs Wijesinghe, a nurse, said that when her second child, Charlie, was born bottom-first on March 13, she and her son were able to leave hospital the next day.
However, she said that the birth was induced to suit the availability of an obstetrician confident in breech births, and that she had been warned had she gone into spontaneous labour earlier she could have had little choice but to have a caesarean.
"At the end of day, the hospital was making the decision for me," she said.
About 4 per cent of babies are in a breech position at term, which means the baby's bottom or feet (instead of its head) is facing towards the birth canal.
About 87 per cent of Australian women with such a baby undergo a caesarean.
But guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists say some experts believe that "with adherence to strict criteria" planned vaginal delivery may be an option to offer appropriately counselled and selected women. They say the vaginal delivery must take place in a facility where there is appropriate experience and infrastructure.
Dr Bernadette White, clinical director of obstetrics at the Mercy Hospital, said it was more difficult to plan vaginal breech births in the public system because it was not always possible to guarantee the presence of confident practitioners.
Dr White, a counsellor with the college, said an influential study published in 2000 had battered some doctors' confidence in relation to vaginal breech births.
It showed that it was safer for babies to undergo a caesarean.
"I think the trial did swing people against [vaginal breech births]," Dr White said.
"I suspect it would probably be a minority rather than a majority of obstetricians now in 2017 who would be confident to do a breech birth. Most of those who are [confident] are senior people."
There have been diverging accounts about what led to the closure of Royal Women's Hospital's breech clinic.
It is understood one experienced obstetrician recently stopped performing vaginal breech births at the hospital and that other obstetricians were unwilling to take on his job following a reported "bad outcome" during a vaginal breech birth.
Lisa Dunlop, executive director of clinical operations at the hospital, said the breech clinic role was currently vacant and its services had been incorporated into the daily pregnancy clinic.
"Women who are having care at the Women's for their pregnancy and who have a breech presentation at the end of their pregnancy are continuing to receive specialist and individualised advice and care," Ms Dunlop said.
"This includes the option of an external cephalic version, a procedure to help turn the baby into the correct head down position ahead of labour.
"Women who present in labour with a breech will continue to receive care best suited to their individual circumstance. However, the decision resides with the mother regarding the choice of a vaginal or caesarean section delivery."
When asked which Victorian hospitals offer the option of planned vaginal birth for breech babies, a Department of Health and Human Services spokesman highlighted the complexity of the procedure.
"Breech deliveries pose a higher risk to babies than normal births and the safety of women and their babies is paramount," he said.