Up until the new millennium, research evidence about the safety of vaginal breech birth compared to caesarean was inconclusive. Most breech babies were born vaginally if the woman fitted the
suitable criteria previously mentioned.
In October 2000 the results of the Term Breech Trial were published, altering the perception of many caregivers about the safety of vaginal breech birth. This large, randomised controlled study involving 2088 women with caregivers experienced in breech birth participating from 121 hospitals in 26 countries. It aimed to settle the long-running debate about whether vaginal breech birth was superior or inferior to caesarean for both mothers and babies.
The Term Breech Trial showed a reduction in babies being injured (or in some cases dying) if the woman had a planned caesarean (1.6%) compared to women who had a vaginal breech birth (5%). Therefore, breech babies born by caesarean have a 98.4% chance of being born uninjured, compared to a 95% chance if born vaginally. At 2 years of age, there were no differences between the two groups of babies in their health or neurological development.
In regards to the mothers, the analysis of this trial and other related studies has now shown that the possible health benefits for some babies may be gained at the expense of increased health problems for mothers having caesarean operations. This is discussed further in
risks involved with caesarean births.
Since the Term Breech Trial, the tendency to perform a caesarean for breech babies has dramatically increased. However, ideally women and their partners should be counselled about the risks and benefits of both vaginal breech and caesarean births to help them make informed decisions that they feel most comfortable with. This decision may also be based on how experienced the caregiver is at delivering vaginal breech babies.