Issues Magazine

C-Section Safer for Breech Babies



There is a tenfold increase in foetal mortality for vaginal delivery of breech births compared with elective C-section, according to a Dutch study published in Acta Obstetricia et Gynecologica Scandinavica. Up to 4% of deliveries are breech births – when the baby is delivered buttocks or feet-first instead of in the head-first position.

The researchers used data from the Dutch national perinatal registry from 1999 to 2007, which includes 96% of all births in The Netherlands. They found that elective C-section rates increased from 24% to 60%, resulting in a decrease of infant mortality from 1.3/1000 to 0.7/1000. Perinatal mortality remained the same in the group of planned vaginal deliveries. The researchers determined that there needed to be 338 cesareans to prevent one perinatal death.

“Our findings suggest there is still room for improvement to prevent unnecessary risk to the infant,” said lead study author Dr Floortje Vlemmix of The University of Amsterdam. “We recommend using measures to turn the baby (external cephalic version) to prevent breech presentation at birth and counselling women who want to proceed with a vaginal breech birth.”