The following information outlines the main health concerns that may be associated with a vaginal breech birth. For women with a breech baby considering how they will give birth, being fully aware of the potential problems may help with making a decision you feel comfortable with. The main issues for babies born vaginally in a breech position can include:
Baby's head unable to be born
Type of breech position
Experience of the caregiver
Caesarean birth
Risks for the baby
Induction and augmentation
Epidurals
Forceps and episiotomy
Baby's head unable to be born. The main concern for breech babies born vaginally (and caregivers delivering breech babies) is that their body will be born easily, but their head will not come down the birth canal, literally becoming stuck (happening in about 0.9% of vaginal breech births). This can result in severe injury with the caregiver's attempts to help the baby to be born or in some cases the death of the baby.
When a baby is born head first, the largest part of their body leads the way, allowing the woman's cervix to fully dilate and for the baby's head to spend time (up to an hour or two) in the birth canal to mould to the shape of the woman's pelvis facilitating the baby's descent. Once their head is born, the body usually easily follows.
In breech births, occasionally the cervix does not dilate enough to allow the baby's head to pass through. This is more commonly associated with very premature or relatively small babies (less than 2, 500 grams or 5lb 8oz). In these cases, their bottom is much smaller than their head, meaning the baby can come down the birth canal before the woman's cervix is fully dilated. The woman may need to resist an early urge to push until their cervix is fully dilated, although this may not always be successful. The width of a full
term baby's hip-to-hip is normally similar in size to the baby's head, meaning this is less likely to happen with a normal-sized, full term baby.