Statement - 18 August 2017
About 4 per cent of Victorian women have a breech presentation at-term.
While breech births pose a higher risk to at-term babies compared with none breech deliveries, vaginal breech births are possible in some specific cases, where there are suitably experienced staff.
Up until recently, patients booked through our Pregnancy Day Care Unit who presented with a breech in late pregnancy were referred to an individual clinician who operated a ‘breech service’.
Through this service, these women were provided with specialised counselling and support and advised of the pros and cons of a breech vaginal delivery versus an elective caesarean section. They were also offered the option of an external cephalic version (ECV) where the clinician attempts to turn the baby.
In May this year, the individual clinician who operated the breech service was no longer available to oversee the service. To ensure continuity of care, the Women’s incorporated the breech service into the Women’s Pregnancy Clinics.
This enables the Women’s to continue to provide specialist and individualised advice and care for all patients, including those with a breech presentation at the end of their pregnancy. It includes the offer of an ECV and detailed counselling on various birth options.
Each pregnancy is different and therefore the risks and options vary depending on a number of factors. These include: gestation of pregnancy; size of the baby; type of previous births; type of breech presentation; and other potential complications.
Women who are booked at our hospital and present at the Women’s in labour with a breech will continue to receive care best suited to their individual circumstance.
Our practice has not changed and is in accordance with The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) guidelines.
To ensure the continuity of our breech service, the Women’s is:
- Increasing the number of multidisciplinary simulation training sessions for obstetricians and midwives in relation to at-term breech delivery.
- Continuing to provide women with an ECV during their normal antenatal visit to the Women’s on any day of the week.