November 29, 2010, Updated September 13, 2012

Forget Caesarean delivery for breech babies, normal birth is just fine, claims an Israeli researcher, overturning traditional protocols.


Photo by Moshe Shai/Flash90.
An Israeli researcher is urging obstetricians to relearn how to deliver breech babies.

Babies heading down the birth canal feet first or bottom first are usually delivered surgically. But according to researchers including Prof. Marek Glezerman of Tel Aviv University’s Sackler Faculty of Medicine, many ‘breech’ babies and their mothers would fare much better with a natural vaginal birth.

Glezerman’s conclusions challenge the protocol most physicians have relied on since a large-scale international study in 2000 universalized the practice of delivering breech babies – about four percent of cases – by Caesarean section (C-section).

Natural birth benefits warrant re-education

However, the scientific data publicized recently by Glezerman in major obstetric journals and at the Second International Breech Birth Conference in Ottawa, Canada, indicates that breech babies are no more endangered during vaginal delivery than during C-section.

Natural birth also puts mothers at much lower risk of medical complications and avoids related problems with breastfeeding and future childbirths.

Glezerman explains that a C-section is a major surgical procedure that not only carries the same risks as any operation but also decreases chances that a new mother will be able to breastfeed.

In addition, once a woman has had a Caesarean childbirth she will most likely have to undergo the procedure for subsequent babies – even if they are not breech – because the surgery leaves her uterine walls and supporting muscles susceptible to rupture under the stress of contractions.

While it can be trickier to deliver a breech baby vaginally, Glezerman is convinced that its benefits are significant enough to warrant re-educating two generations of medical professionals with little training in how to do so successfully.

Breaching the breech protocol

“The skill has disappeared,” he explains. “We are trying to unite obstetricians and midwives in the field to revive vaginal delivery for breech presentations. We need to go back to the future and relearn what has been forgotten.”

To further this goal in Israel, Glezerman offers workshops at the Rabin Medical Center to show new gynecologists and obstetricians the techniques for managing different breech presentations and turning the fetus in utero, so that it will emerge headfirst.

He’s crusading for the introduction of similar skills training across the world, backed by scientific evidence supporting a return to more traditional birth methods in cases of breech presentation.

Glezerman emphasizes that physicians still need to be able to recognize situations where vaginal delivery is not the safest option, but urges doctors and midwives to judge each case individually rather than assume a C-section is warranted for every baby in a non-headfirst position.

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