Breech- Delivery Process reconsidered

Berlin In the U.S., a breech baby is normally a sure ticket to a C-section delivery. But here in Germany, more women are asking to have their breech babies delivered vaginally and doctors increasingly are willing to let them try.

Many doctors in Germany say breech birth is an appropriate choice as long as strict criteria are met and the delivery is overseen by an experienced physician. The approach reflects a tendency among German medical professionals to favor noninvasive remedies as a first line of attack against medical problems, doctors say.

"We should know how to do our delivery jobs. It's so easy to do a caesarean—there are no long hours of labor. But it's not natural," said Cornelia Herbstreit, head obstetrician at Berlin's Havelhöhe Community Hospital.

Vaginal breech births overall are more dangerous for babies than caesarean sections. Studies in recent years, however, have shown that a vaginal delivery can be safe under certain circumstances, including how the baby is positioned in the womb.

Most doctors and hospitals in the U.S. won't perform vaginal breech deliveries outside of emergency situations. Still, the American Congress of Obstetricians and Gynecologists, the main professional body for delivery doctors in the U.S., softened its stance on vaginal breech birth in 2006 and reaffirmed the position in 2012.

The group said it may be a "reasonable" option for women depending on the experience of the physician. It cited studies that showed breech birth under certain protocols is no riskier than a planned C-section.

Most babies are positioned head down in the womb by the time they approach their due date. But breech babies are situated so that their feet or buttocks will come out first during childbirth. There are risks to vaginal delivery: If the baby's head gets stuck in the birth canal, it can cause brain damage or even death. About 4% of babies are breech at the end of pregnancy. Before trying a vaginal breech birth, many doctors will attempt to turn the baby by applying pressure to the mother's belly in a procedure called an external cephalic version.

Carolin Hofmann, a risk analyst at a bank near Frankfurt, tried in vain to turn her baby after she learned it was breech. On the advice of her midwife, she lay on the floor every evening with her feet up. She burned a weed called mugwort near her toes—a Chinese medicine therapy called moxibustion that is thought to cause babies to turn. And her doctor at Frankfurt University Hospital, which performs more than 100 breech births a year, attempted external cephalic version.

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