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No more automatic C-section for breech births, says Ob/Gyn Society

Halifax – June 17, 2009 – Physicians should no longer automatically opt for caesarean sections in the event of breech birth, according to new guidelines for Canadian health professionals released today by the Society of Obstetricians and Gynaecologists of Canada.

The guidelines are based on a comprehensive review of research and clinical evidence regarding the safety and outcomes of vaginal breech births compared with that of caesarean sections. In the final weeks of pregnancy, most babies will align themselves in the womb into a head down position, in preparation for birth. However, in approximately 3-4% percent of pregnancies, the baby will not align into this birthing position, and instead will present as a breech pregnancy, with its feet or buttocks positioned downwards towards the birthing canal.

“Breech pregnancies are almost always delivered using a caesarean section, to the point where the practice has become somewhat automatic,” said Dr. Robert Gagnon, a principal author of the new guidelines and Chair of the Society’s Maternal Fetal Medicine Committee. “What we’ve found is that, in some cases, vaginal breech birth is a safe option, and obstetricians should be able to offer women the choice to attempt a traditional delivery.”

Lack of Training

Canadian women carrying breech babies are typically not considered as candidates for a vaginal childbirth, and instead are recommended for a caesarean section. As such, there exists a significant cohort of Canadian obstetricians who lack training in vaginal breech birth.

“The evidence is clear that attempting a vaginal delivery is a legitimate option in some breech pregnancies,” said Dr. André Lalonde, Executive Vice-President of the Society of Obstetricians and Gynaecologists of Canada. “The onus is now on us as a profession to ensure that Canadian obstetricians have the necessary training to offer women the choice to deliver vaginally when possible.”

In light of the lack of training, health professionals, universities, and hospitals will need to work together to help ensure that Canadian health centres are prepared to accommodate women who choose to attempt a trial of breech vaginal delivery.

The society is also cautioning that many breech deliveries will still require a cesarean section, and that a vaginal birth is not recommended for some types of breech positions. In situations where a vaginal delivery is an option, the delivery should take place in a hospital setting. An experienced obstetrician should be present to attend the delivery and to offer a cesarean section if the labour does not progress smoothly or if complications arise.

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For More Information

Guideline
Read the complete text of the SOGC’s new guideline, Vaginal Delivery of Breech Presentation

Editorial
Vaginal Breech Delivery Guideline: The Time Has Come
Dr. André Lalonde

Commentary
Breech Birth can Be Safe, But is it Worth the Effort?
Dr. Andrew Kotaska

Backgrounder
About Breech Birth

Public Education Brochure
Breech Childbirth

Media Contact

Mike Haymes
Media Relations Officer, SOGC
Tel: (902)440-3263

Natalie Wright
Director of Communications and Public Education, SOGC
Tel: (613) 240-0169

 

About the SOGC

The Society of Obstetricians and Gynaecologists of Canada (SOGC) is one of Canada’s oldest national specialty organizations. Established in 1944, the Society’s mission is to promote excellence in the practice of obstetrics and gynaecology and to advance the health of women through leadership, advocacy, collaboration, outreach and education. The SOGC represents obstetricians/gynaecologists, family physicians, nurses, midwives and allied health professionals working in the field of sexual reproductive health. For more information, visit www.sogc.org.

Last Updated June 12, 2009