Women to be offered planned vaginal breech deliveries.

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Recent research has suggested that elective caesarean section (CS) for breech delivery at term is the safest option for most women. However, CS delivery is not without risks for subsequent pregnancies including life-threatening problems for mother and baby such as uterine scar dehiscence, placenta praevia or placenta accreta.

A paper published in The Obstetrician & Gynaecologist (TOG) sets out the instances when vaginal breech births could be offered, instead of c-sections. Basil van Iddekinge from Johannesburg, who authored the paper, said "Since the 'Term Breech Trial' was published in the Lancet in 2000, CS has been widely adopted as the delivery method of choice for women presenting with a persistent breech presentation at term. However, with potential risks to mothers in future pregnancies being identified, it seems reasonable to offer women the option of a planned vaginal breech delivery at term provided strict selection criteria are met."

"Whether this option is offered or not, teaching of vaginal breech delivery (and external cephalic version) must continue to remain an integral part of the trainee programme otherwise this option will not be viable in the future. It is...