In any normal pregnancy it is usual for the baby’s head to be positioned in the uterus and the baby delivered head first at the onset of labor.
Occasionally some babies are not in this regular position and it is the baby’s bottom which is in the uterus with its tiny legs folded at the front of its body. This is referred to as the breech position.
The dangers associated with a breech delivery are that, while the baby’s bottom should slip out easily enough from the pelvis, the head may become trapped by its chin which can lead to oxygen starvation, since the umbilical cord ceases to function once it has exited the pelvis.
In such a ‘trapped head’ situation, it is essential to get the baby out of the mother’s pelvis immediately to avoid the death of the baby from oxygen starvation. Such risks can be eliminated by having the position of the baby in the womb checked at about week 34 either by the midwife or by having an ultra scan. Then the decision can be made as to whether to proceed with a vaginal delivery or have the baby removed by cesarean section.
The breech position can be caused by many factors. The fetus may be unduly small and only loosely fitted in the uterus, or if there are twins one fetus can push the other into the breech position. If the female has had many children, then her uterus may be stretched allowing the fetus to move into the breech position.
If the baby is in the breech position then for some mother’s vaginal delivery can be perfectly safe. The delivery procedure needs to be carefully watched over, and sometimes the vaginal opening is enlarged to facilitate the birth and avoid the ‘trapped head’ condition from occurring.
Faced with a breech birth many doctors however, prefer to perform a cesarean section for the safe removal of the baby. This operation carries a degree of risk to the mother, and many mothers do indeed opt for this type of cesarean delivery rather than place the baby at risk by having a vaginal breech delivery.