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About Breech Birth

Breech positions

Most babies are positioned head down in the womb. This is so they can come out of the birth canal (vagina) head first. Sometimes, the baby is positioned so the feet or buttocks will come out first during childbirth. This is called a breech presentation.

Frank Breech: Frank breech is the most common type of breech position. In this position, the baby is positioned buttocks first, with legs straightened and sticking up directly in front of its body, so that the baby’s feet are near its head. A trial of vaginal labour is possible in some situations.

Complete Breech: The baby is positioned buttocks first, with legs bent at the knee and positioned close to the buttocks. A trial of vaginal labour is possible in some situations.

Footling Breech: The baby is positioned feet first with one or both feet pointing directly downward towards the birthing canal. Trial of vaginal delivery is not recommended.

When is breech vaginal birth not an option?

The new guidelines outline circumstances under which attempting a vaginal breech birth is not recommended, including:

Any situation in which a caesarean section would normally be recommended, even if the baby were not in a breech position.
If the baby weighs less than 2500g (5.5 lbs.) or more than 4000g (8.8 lbs.).
If the baby presents as a footling breech.
If the mother has a narrow or small pelvis, which could make vaginal delivery difficult.
If the baby’s umbilical cord is positioned in such a way that it is likely to become entangled or compressed during delivery.
If the head of the baby is in hyperextension.

These new guidelines are only for healthy term (after 37 weeks) pregnant women and are not applicable for preterm deliveries.

How many pregnancies are breech presentation?

Breech presentation affects 3-4% of all pregnant women reaching term.¹ Based on the latest birth figures for Canada, this translates into approximately 11,000 to 14,500 pregnancies with a baby in breech position at time of delivery each year.²
Earlier in the pregnancy, there is a higher likelihood that a fetus will be in a breech position. At 28 weeks into a pregnancy, approximately 24% of fetuses will be in a breech presentation.¹

For More Information

Public Education Brochures

References

¹ Breech presentation and delivery. In: Cunningham FG, Hauth JC, Leveno KJ, Gilstrap L, Bloom SL, Wenstrom KD, editors. Williams obstetrics. 22nd ed. New York: McGraw-Hill Medical Publishing Division; 2005. p.565-86.

² Number of Births, By Province and Territory. Statistics Canada, CANSIM, table 051-0004 and Catalogue no. 91-213-X. (http://www40.statcan.ca/l01/cst01/demo04a-eng.htm)

Last Updated June 12, 2009