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The case for and against vaginal breech delivery

^1. Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
^2. Chelsea and Westminster Hospital NHS Foundation Trust, London, UK Email: pennhughes{at}ntlworld.com (corresponding author)

Key content:

• Critics continue to raise doubts about the conclusions of the Term Breech Trial.
  
• Subsequent European population studies have also concluded that the breech neonate benefits from elective caesarean section.
  
• Smaller population studies demonstrate the success of vaginal delivery in selected populations.
  

Learning objectives:

• To be aware of criticisms of the Term Breech Trial and other literature that contradicts its findings.
  
• To understand the difficulties of selecting suitable women for trial of vaginal breech delivery.
  
• To be able to use current evidence when counselling women about their delivery options.
  

Ethical issues:

• How can the neonatal advantages of caesarean delivery be balanced with maternal morbidity and the potential for complications in future pregnancies?
  
• Should vaginal breech delivery still be considered a safe mode of delivery?
  

Please cite this article as: Deans CL, Penn Z. The case for and against vaginal breech delivery. The Obstetrician & Gynaecologist 2008;10:139–144.

Keywords caesarean section / maternal morbidity / maternal mortality / perinatal morbidity / perinatal mortality