Breech Baby? Making an Informed Choice as a parent (Vaginal birth VS c-section)

Are you near your term, and baby is not head down, but butt first? This happens to about 4% of babies at term.

Expecting a breech baby can feel overwhelming; but whether your baby stays breech or you’re exploring ways to turn them head-down, there are options, and professionals to support you making an informed decision.

You are not always bound to have a C-section automatically. Ultimately, this is a discussion for you to have with your care team, looking at a constellation of factors from your side and baby's side.

Here are some key information for a Berlin birth doula (that is, a non-medical professional).

different forms of breech presentations, as described in a German midwifery textbook

Is Vaginal Breech Birth Safe (for babies at term)?

As a doula, I'm not a medical professional. And my role is NEVER to tell anyone what is good/bad, safe/unsafe for them. In some cases, a C-section will be the only option. Ultimately, it's going to be up to you and your medical team to find the right decision through clear communication and informed consent.

But as a doula, I want families to truly understand their options. Sometimes vaginal breech birth is an option too. I have trained with Breech without borders to be able to offer objective and evidence-based doula counselling and emotional support to families.

When it comes around vaginal breech birth, understanding your options will help you make an informed decision for yourself and your baby!

To answer the question, “Is vaginal breech birth safe?” you must look at both short- and long-term risks and benefits to the baby, to the mother, and to the mother’s future pregnancies and future babies. Ultimately, this is a discussion for you to have with your care team, looking at a constellation of factors from your side and baby's side.

Many people assume a C-section is automatically safer, but C-sections carry risks too: a C-section also represents a risk for the mother, baby but also future pregnancies. This has to be weighted against the potential risk of a vaginal breech birth. Discuss this with your care team, to decide together what is best for your situation.

data from breechwithoutborders.org their paper "The Bottom Line on Breech" is a great data source

It is difficult to find reliable, comprehensive data when it comes to vaginal breech births. The outcomes have not been really consistently studied.

I really encourage you to document yourself, and do some research to be able to make an informed-decision that feels right for you. Great resources include breechwithoutborders.org and evidencebasedbirth.com. Also this Podcast from Evidence Based Birth. And of course, find medical professionals with whom you can have an open conversation about this.

You Need A Skilled Team for Breech

It’s important to understand that it’s key to find a team that has the right skills/setting to support a vaginal breech birth.

Key questions to ask potential maternity team:

• How many breech births do you handle each year?

• How many practitioners are trained and experienced in breech?

• How likely is it that on the day I come, there will be a provider who is trained in breech?

• What's your philosophy around  vaginal VS c-section breech birth? What do you see as the risks/benefits for each birth mode and why?

• What's in place in your service to support my baby and myself in case complications arise?

You can "interview" providers... it is important that you make a real choice as to where, how and with whom you give birth.

Breech Birth in Berlin

In Berlin, BEL (Beckenendlagegeburt aka breech birth) is not allowed in ❌Geburtshaus or ❌ home births. You will therefore give birth in a hospital, because breech births are inherently carrying more risk than cephalic births.

Many clinics say they do vaginal breech birth, but asking key questions to learn more about the team's experience and philosophy is important for you to be in good hands and feel at ease.

Some clinics that I know of, offer significant expertise in supporting breech birth:

• DRK Westend – comprehensive counselling and 24/7 on-call availability for breech births - You may contact Dr. de Sousa Mendes for counselling on breech

• Waldkrankenhaus Spandau 

• Havehöhe

Supporting Families Through Informed Choices

Empowering families to make informed decisions is crucial. Here are some strategies:

• Meet providers: Discuss your wishes, fears, and preferences. When asking for facts and data, ask "how is this relevant to me/my baby?"(e.g. risk factors are different for 1st time mothers, babies estimated over-under weight etc.) There is a constellation of things to consider

• Ask facts, not opinions: Get data on breech births per year (attempts (that ended up in C-sections vs successes), clarify experience, success rates, and team readiness. Ask about your options for breech birth VS C-section and what it means for you in terms of benefit/risk ratio.

• Communicate clearly: Form preferences about key interventions and comfort measures (pain management medicated/unmedicated). Write a birth plan that captures your preferences for labour and birth, discuss it with the team ahead of time, for clear communication and shared goals.

• Explore different clinics: Meet providers and ask them your questions If you are planning a vaginal brech birth make sure you found a skilled and confident team who will be able to support you whenever you are in labour. If your team isn’t confident or experienced with breech birth, it’s okay to seek a better match. You are always allowed to look for a second medical opinion.

• Educate yourself: Research and read. Great resources include breechwithoutborders.org and evidencebasedbirth.com. For nerds ;) watch videos, listen to podcasts to understand the basic physiology of breech birth...

• Hire a doula :)

Every family deserves an informed, empowered birth experience and to work with a team that truly aligns with their goals and needs.

Hiring a Doula

Hiring a doula is a great way to get continuous support throughout pregnancy, birth, and postpartum. As a doula, I provide non-medical guidance, and emotional & physical support and presence during labour and birth (& beyond)

Anne Matei, doula

Book your free call

I currently offer discounted counselling for parents with breech babies who can not afford to pay full price for a birth companionship. I believe every parent deserves to be empowered by understanding their options and making a real choice for their birth. Get in touch to find out more.

Gallery of videos of breech births

https://www.breechwithoutborders.org/videos/

and a ton more resources including articles from Dr Rixa Freeze

Anne Matei doula in Berlin