Breech babies have a much higher risk of death if they are delivered vaginally rather than by caesarean section, a new study has found.

Babies in the breech position are delivered feet or buttocks first, rather than head first. An estimated 4% of deliveries are breech.

A previous study carried out in 2000 saw a big fall in newborn deaths among women who had a planned caesarean section if their baby was breech. Following the publication of those results, elective caesarean rates for breech births increased in many countries.

However, some women would still rather attempt a vaginal birth even if their baby is breech.

Dutch scientists decided to assess whether the increases in caesarean sections related to breech deliveries had any impact on neonatal outcomes in the long-term. They looked at over 58,000 women who delivered breech babies at full-term.

The study found that if a baby is breech, there is a 10-fold increased risk of foetal death if the baby is delivered vaginally rather than by caesarean section.

"While elective C-section has improved neonatal outcomes there is still a good number of women who attempt vaginal birth. Our findings suggest there is still room for improvement to prevent unnessary risk to the infant. We recommend using measures to turn the baby to prevent breech presentation at birth and counselling women who want to proceed with a vaginal breech birth," commented the study's lead author, Dr Floortje Vlemmix, of the University of Amsterdam.

Details of these findings are published in the journal, Acta Obstetricia et Gynecologica Scandinavica.

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