Vaginal Delivery vs Cesarean Section for Breech Presentation - Dissertation Example

Current practice, as supported by the NICE and RCOG Guidelines (2001) discourages women from having vaginal deliveries when their babies are presenting in a breech position. Many midwives have only ever experienced vaginal breech deliveries in a simulated environment. Since practice is now dominated by the opinion that the safest option for these babies is a cesarean section and the opportunities to gain experience in safe vaginal breech delivery are limited, the dominance of the cesarean section is reinforced.

This paper aims to highlight the evidence that underpins the current practice as well as investigate the emerging evidence that is the basis for certain midwives now considering breech vaginal birth to be a safe option. Historically vaginal deliveries were the chosen method for the delivery of babies with a cephalic or breech presentation. Something about the history of mortality The mortality rate for both mother and child for vaginal deliveries has also varied with the introduction of modern methods of medicine (Fischer, 2012).

  These rates saw a decrease especially for complicated deliveries where cesarean births have been applied.  The current indications for cesarean births in developed countries include breech babies along with fetal distress, malposition, malpresentation, placenta previa, and other related complications (Fischer, 2012).  Some of these complicated births have been delivered vaginally even though the risk for these births has been considered significant. At present, the training for Obstetricians has mostly related to the delivery of breech babies via cesarean section.

This development has been re-evaluated by midwives because some midwives believe that obstetricians must equally train in normal deliveries of breech babies, especially as women’s options have been limited by the risks involved in the birth as well as the decreased skill of midwives (Jadoon, 2008). Breech presentation deliveries are deliveries where the fetus is at a longitudinal position, with either the buttocks or the feet presenting at the cervical area during delivery. This presentation is seen at about 3-4% of all term deliveries (Fischer, 2012).

This type of presentation may be attributed to prematurity, uterine malformations, placenta praevia, multiple births, and sometimes fetal abnormalities (Fischer, 2012).