If all goes according to plan with your birth, your baby will come out headfirst. He or she might be in a standing position up to the 36th week of your pregnancy, but after that, the position will be shifted in preparation for delivery. At 96%, almost all babies are naturally in the right position when labor begins. If your baby is in a breech position at 37 weeks, it means that he or she has not shifted to the proper position for birth, and his or her feet are still down by your bladder. Some doctors might try to manually reposition the baby in a process called external cephalic version, but the risk of your baby going right back to breech is too high in many cases.
Historically, most breech babies are removed with a cesarean section. However, if there are doctors and nurses specifically trained in breech births available, a breech baby can be safely delivered vaginally. Many women opt for this option, since they were looking forward to having a more natural birth. Especially if you’ve delivered a baby vaginally before, your doctor might recommend going forward with the vaginal birth as long as he or she is well-trained. A breech birth will also be safer if there are cesarean section facilities close by should an emergency C-section be required.
Unfortunately, there are some factors that make a breech birth unsafe. If your baby’s feet are under his or her bottom, it is considered a kneeling breech, and a vaginal birth is nearly impossible. Luckily, this position is uncommon. Your doctor will also recommend a cesarean section if the first of a set of twins is breech. A vaginal breech birth puts the second twin at risk, so it is not considered safe. A cesarean section will also be performed if you have other conditions that make a vaginal birth unsafe, such as a narrow pelvis or pre-eclampsia. Breech birth is risky on its own, so it shouldn’t be combined with other pregnancy conditions.
If your baby is in the breech position at the time of birth, a cesarean section will not necessarily be required. As long as your delivery team is knowledgeable in breech deliveries, you can have a safe and successful breech baby. If your baby is still in the breech position at 36 weeks, talk with your doctor about the possibility of breech birth.
Source: Andrew Kotaska: Breech Birth Can be Safe, But Is It Worth the Effort? Journal of Obstetrics and Gynecology Canada Volume 31 Issue 6 pp. 553-554 2009