Vaginal breech birth: Is it safe?
We sat down with Sasha Hopkins, a private midwife and founder of Barefoot Midwifery, to talk about breech birth—a topic that can raise a lot of questions for expecting parents.
One of the most common questions she hears is, “Is vaginal breech birth safe?”. “The safety of vaginal breech birth really depends on a few key factors,” Sasha explains. “One of the most important is the experience and confidence of your care provider.” Each care provider brings their own background and beliefs to birth. “If a provider primarily performs caesareans for breech babies, that’s the option they’ll feel most comfortable with,” Sasha says. “But if they’ve attended multiple vaginal breech births, they’ll likely feel confident supporting that instead.” This comfort level can be crucial, as a provider’s hesitations or anxieties could potentially impact the outcome of the birth. “You want someone who’s not just skilled but also comfortable with the path you’re choosing.”
Historically, vaginal breech birth was a common practice in the home setting among traditional midwives and some obstetricians. Overtime birth transitioned to the hospital where vaginal breech births continued to be offered. Sasha points to a study called the Term Breech Trial as a turning point: “After this study was published stating caesarean was the safest option, there was a sharp decline in vaginal breech births and an increase in caesarean deliveries. Unfortunately, the study had a lot of issues—like not sticking to the inclusion criteria and small sample sizes—and it was later found to be inadequate.”
Although the study’s recommendations were eventually withdrawn, the damage was done. “The art of vaginal breech birth was almost lost,” Sasha reflects, “but recently, midwives and obstetricians around the world, including here in Australia, are reclaiming that knowledge.”
So, is vaginal breech birth safe today? Sasha believes it can be, but stresses that there are several important factors to consider. “First, ask yourself where you feel safest—at home or in a hospital?” she advises. “Does your provider understand and support physiological breech birth? It’s essential that you and your care provider are on the same page.” Sasha also emphasises the importance of discussing any requirements your provider may have, such as continuous monitoring or starting labour before 42 weeks. “Ask yourself how these conditions make you feel, and whether they align with your birth preferences. If not, will your provider still support you?”
It’s also important to consider your support network. “Do you have people around you who trust your decision-making and believe in the path you’ve chosen?” Sasha asks. “Having that support is crucial.”
Navigating these decisions can feel overwhelming, but Sasha encourages parents to trust their intuition. “It’s not easy to take that first step, but following your instincts can help guide you in achieving your desired birth” she says. For parents facing the decision between a vaginal breech birth or a caesarean, Sasha recommends checking out Breech Without Borders, an organisation that provides up-to-date, evidence-based information on breech birth. “They offer an online course called Breech 101, which is great for parents, doulas, and childbirth educators,” Sasha notes.
You can learn more at Breech Without Borders.
To connect with Sasha Hopkins, visit her website or social media pages:
https://www.barefootvibes.au
https://www.instagram.com/sasha_barefoot_vibes/
https://www.facebook.com/BarefootVibes1