How common are breech births in the UAE?
In the UAE, breech-presenting babies occur in roughly 3-4% of all full-term deliveries, and are more commonly witnessed in pre-term deliveries. Breech positioning is more common with women having their first child and is sometimes associated with an abnormality in the baby such as neuromuscular disorders, or in the mother, such as the shape of the womb. Today, vaginal breech births are relatively rare, as breech presentation is often detected before labour begins and doctors will offer an external cephalic version procedure – the procedure to turn the baby to the normal birthing position.
Why are breech births thought to be less safe?
In 2000, a large trial in the UK called the Term Breech Trial, compared the outcomes between planned Caesarean sections and planned vaginal births in over 2,000 women. The results showed that women who had a Caesarean section had fewer problems in the short-term and fewer infant deaths [although a 2006 study in France and Belgium went on to find that planned vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to women.] Mothers may still opt for a vaginal birth even when they have a breech pregnancy for a variety of reasons, such as; a personal choice to experience a natural birth, some stigma around Caesarean births, and reduced risk to the mother during labour.
How effective is the ECV in turning the baby and are there any risks?
As breech vaginal birth is difficult and considered high risk, your doctor may suggest turning your baby to the head first position. This procedure is external cephalic version (ECV). It is generally safe and has a 60% success rate, however there are some risks to be aware of, such as in 5% of cases the procedure may induce a temporary change in the baby’s heart rate.
What would you advise a woman who’d like to deliver her breech baby naturally?
We understand that each mother has her preferred birthing plan, and despite the risks some mothers would prefer to opt for a vaginal birth. Firstly, we would recommend understanding all the risks associated to both yourself and the baby. If the mother and baby are deemed low risk and opt for a vaginal breech birth, this must be done in a hospital that has a neonatal intensive care unit, under the presence and guidance of a skilled obstetrician and midwives. In addition, there should be very close supervision of labour progress and continuous fetal monitoring throughout labour and delivery.