Following a recent post, where a student mentioned that she had to "birth a breech" during her Viva, I thought it would be good to start a discussion on the way we are taught this technique.

During my training I was taught the necessary manoeuvres to deliver a breech baby vaginally, with the woman on her back and in lethotomy. Since qualifying this is a skill that I have revisted every year during the "Skills Drills" days that I attend.

We are taught "hands off the breech"! - This is because handling the baby before the head is born could cause the baby to take a gasp, before the head is born. The manoeuvres we are shown are anything but "hands off"! See this page.

Why are we shown these techniques and required to show our competance at using them? It wis because the women we see in hospitals are required to be flat on thier backs. Of course the breech baby will need assistance to be born, with the woman in this position! Why can't we be taught an alternative?

As far as I can tell a true "hands off" delivery can only be achieved when the woman is on all-fours, or in an upright position. There is a great photo of a vaginal breech delivery here. In this position the baby's body is suspended very naturally and, with the aid of gravity, follows the curve of the pelvis as it is born, without the need for all the complicated manoeuvres shown in the first link that I gave.

I have only ever cared for women where the breech baby is born with the mother in the lethotomy position. It would be great to hear from any midwives who have experience with vaginal breech births.

Breech Birth, by Benna Waites is a really good read on this topic.

Enough from me. What do you think.....???

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