Scientific publication about the successful approach to vaginal breech delivery at Maria Middelares General Hospital

After a 2000 study in The Lancet described vaginal breech deliveries with unjustified negative results, they were not performed for quite a while. Notwithstanding, the results appear to be favourable for the babies when there is a good selection process and, in those circumstances, there are also fewer risks for the mothers. For this reason, it is important that breech delivery be reintroduced and gynaecologists hone their breech delivery skills.

The publication outlined the various steps that are necessary to roll out a successful breech delivery programme: a breech consultation (where the criteria for a vaginal breech delivery and all the pros and cons of a vaginal birth versus a Caesarean section are reviewed), the walking epidural (where leg mobility is sufficient to allow for various positions during labour and birth), and finally, the ongoing training of the whole team (gynaecologists, midwifes, anaesthesiologists and paediatricians).

From the study of 111 women who registered for a breech consultation (May 2019 - August 2021), the following results were obtained: 86.5% (n = 96) of the patients with a baby in breech position fulfilled the selection criteria for a vaginal breech delivery. The choice of a vaginal breech delivery is completely free: 77% of the parents (n = 74) agreed to it. In the end, 54% (n = 40) were able to give birth vaginally. The other women had a Caesarean section.

Patient feedback

Expectant parents often approach the breech consultation with some reservations and are rather inclined to elect for a Caesarean section. However, after receiving extensive information during the breech consultation and hearing that they fulfill the criteria, they are usually highly motivated for a vaginal breech delivery. They are then very positive over the freedom to choose and the time investment from the whole team.

Would you like to know more?

• Casteels, M., Podevyn, K., Vanoverschelde, H. et al. 2021. ‘Implementation of a breech program in a Belgian obstetric team’, International Journal of Gynaecology & Obstetrics. DOI: 10.1002/ijgo.14003.

• General practitioners magazine Hallo (Maria Middelares General Hospital) ‘Tackling the breech, a unique obstetric project of Maria Middelares General Hospital’.