Natural breech birth is low risk for babies: study

 Photo: Getty Images

The risks of a baby dying or suffering complications during a natural breech birth are "very small", experts say.

The vast majority of babies are born head first, but of those that are breech (positioned feet first), most will be born by caesarean as is advised by midwives.

The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, found that although this option is safer, the risk brought by vaginal delivery was still very low.

Common types of breech presentation.
Common types of breech presentation.  Photo: MedlinePlus

The large-scale research analysed 27 studies with a total sample size of more than 250,000 women from around the world to determine the risks of mortality associated with planned vaginal breech delivery from delivery up to seven days after the birth.

It found that the overall death rate from planned breech vaginal delivery was 0.3 per cent, while for planned caesarean it was 0.05 per cent - about one in 300 and one in 2,000 respectively.

This was lower than the rates in a World Health Organization (WHO) study on babies born head-first, which found the risk of foetal and neonatal deaths to be 0.39 per cent and 0.38 per cent respectively.

Co-author Yifru Berhan, professor of obstetrics and gynaecology at Hawassa University in Ethiopia, said: "Our results show that the relative risk of perinatal mortality and morbidity was between two and five times higher in planned vaginal breech delivery compared to planned caesarean section birth. However, the absolute risks were very small.

"Although the controversy is still unresolved, our study substantiates the practice of individualised decision making around delivering a breech baby.

"Future research should focus on a comparative study on vaginal breech and non-breech delivery."


Professor Alan Cameron, vice president of clinical quality for the Royal College of Obstetricians and Gynaecologists (RCOG), said, "This is a very interesting study which uses all of the existing data on breech delivery to determine the absolute risks of vaginal breech birth to the baby.

"The Royal College of Obstetricians and Gynaecologists currently recommends that caesarean delivery is the safest mode of delivery for the baby when in a breech position.

"However, there are benefits and risks associated with both caesarean delivery and vaginal breech birth, and women are encouraged to discuss and weigh up the options with their obstetrician so they can choose the best plan for themselves and their baby."