Learning that your baby is breech can bring a whirlwind of emotions. You might feel anxious, especially if your care provider has emphasized cesarean as the safest option. In our culture, the idea of a breech birth often comes wrapped in a cloud of fear and uncertainty. Many of us have seen dramatic scenes on TV or in movies where a breech baby is portrayed as a dire emergency, requiring intervention for the mother and baby to come through safely. It’s no wonder so many women feel afraid at the thought of a breech position.
In reality, the conversation around breech birth is far more nuanced. With the right support and a skilled provider, vaginal breech birth can be a safe and empowering choice. Before training extensively in breech birth, I shared many of these concerns. I understand how natural it is to worry, especially with the narratives we’re exposed to. However, as I delved deeper into the world of breech birth, I learned that it isn’t a guaranteed emergency; in fact, in reality, it is just another variation of normal. With experience and a focus on physiological birth, I’ve seen firsthand how breech birth can be a calm, well-supported experience.
I aim to share this shift in understanding here. Women deserve to know that cesarean isn’t the only option. Breech birth, when supported by an experienced provider, can be a safe and informed choice that aligns with your values and birthing goals. This article explores the evidence, addresses common concerns, and offers the knowledge needed to help you make an informed decision that feels right for you.
What Is Breech Birth?
When a baby is breech, it means they are positioned bottom or feet down in the womb rather than head down, which is typically the preferred position for birth. In a head-down or “vertex” position, the baby’s head engages with the pelvis, allowing a smoother progression through the birth canal. However, a breech position means the baby’s bottom or feet would be the first part to engage with the birth canal, presenting unique considerations for the mother and care provider.
There are several types of breech presentations:
- Frank breech: The baby’s bottom is down with legs extended upward and feet near the face.
- Complete breech: The baby’s knees are bent, with feet and bottom positioned to come down together.
- Footling breech: One or both of the baby’s feet are positioned to come out first, which is less common but can be managed safely with skilled support.
Babies frequently shift positions throughout pregnancy, often turning head-down as birth approaches. For most, this natural movement happens between 32 and 36 weeks, as they settle into the position they’ll maintain for labor. However, approximately 3-4% of babies remain in a breech position as the due date nears. This can occur for various reasons, including the shape of the uterus, placental placement, or the presence of multiple babies.
The default recommendation in many modern healthcare settings is to deliver breech babies via cesarean section. While cesarean is a valid choice and can be a safe option for some breech births, vaginal breech birth remains an option worth considering for many women, especially when attended by a provider trained in physiological breech techniques. Vaginal breech birth, when carefully planned and supported by skilled hands, can be safe and may even come with advantages, such as shorter recovery times for the mother and a reduced risk of surgical complications.
Vaginal breech birth also emphasizes respect for a mother’s autonomy and values. Many women who seek a vaginal breech birth do so because they desire a low-intervention approach, one that aligns with their vision for a natural, empowered birth. When supported by a qualified provider, this approach can be adapted to various birth settings, from hospitals to birth centers and even home births. A well-supported vaginal breech birth allows women to have greater control over their birthing experience, a sense of agency, and the satisfaction of making a choice that feels right for them and their baby.
In recent years, more providers are revisiting breech birth practices and acknowledging that, with the right expertise and support, vaginal breech birth can be a viable and safe option. This shift is about more than just technical skills; it’s about honoring each woman’s right to make an informed choice that aligns with her unique needs and preferences.
Key Values in Breech Birth: Your Rights, Your Choices
Choosing how to approach a breech birth goes beyond simply picking a birth plan—it’s about understanding the values that uphold safe, supportive, and respectful care. Misunderstandings and fears have historically surrounded breech birth, but with the right values at its foundation, it can become an experience of autonomy and empowerment. Here are the core principles that guide compassionate breech birth care: autonomy, trauma-informed care, cultural sensitivity, and respect for physiological birth.
1. Autonomy: Your Right to Choose
At the heart of every safe and empowering breech birth is a commitment to a mother’s right to make her own informed decisions. Autonomy means that you are the leader of your birth experience, fully in charge of the decisions that affect your body and your baby. You have the right to receive clear, unbiased information on all your options, including both the benefits and risks of a vaginal breech birth versus a cesarean. The key to true autonomy is that there should be no pressure, coercion, or scare tactics—just a commitment to provide information and honor your choices.
A provider committed to autonomy will support you even if your decision diverges from typical recommendations. They understand that each birthing journey is unique and respect that your priorities and values might lead you to different conclusions than others. For example, you might place a high value on avoiding surgery, or you might prioritize a birth experience with minimal intervention. Whatever your decision, a supportive provider should empower you to make the best choice for your body and baby, helping you feel confident and in control.
2. Trauma-Informed Care: Compassion and Respect in Every Interaction
Birth is a life-changing event, and for many women, it brings emotional complexities. Some may carry fears from previous experiences, while others may have trauma that makes the idea of giving birth—especially to a breech baby—feel overwhelming. Trauma-informed care is an approach where your emotional well-being is prioritized at every step. Trauma-informed care providers approach you with compassion, ensuring you feel safe, heard, and respected.
In trauma-informed breech care, a provider will always ask for permission before touching or performing any procedure, giving you control over your space and your experience. This approach fosters a safer environment where you can feel secure and supported. Knowing you can pause, ask questions, or refuse anything that makes you uncomfortable can alleviate anxiety, allowing you to focus on the birth itself. When your emotional needs are met alongside your physical needs, the experience becomes more empowering and less stressful.
3. Cultural Sensitivity: Honoring Your Beliefs and Values
Your birth experience should be as unique as yours, which means recognizing the personal, cultural, and spiritual beliefs that shape your values. Cultural sensitivity in breech birth care acknowledges that there’s no “one-size-fits-all” approach to childbirth. Whether you have certain traditions you’d like to incorporate, spiritual practices that bring comfort, or simply a unique vision for how your birth unfolds, your provider should respect and honor those wishes.
A culturally sensitive provider will take the time to understand what matters to you, adjusting their approach to align your experience with your beliefs. For example, if you prefer a quieter birthing environment or wish to include specific rituals, a supportive provider will help create a space that reflects these choices. Breech birth, like all births, can be a profound and sacred experience, and it should feel like a celebration of who you are and the values you hold dear.
4. Respect for Physiological Birth: Trusting the Natural Process
One of the most reassuring values in breech care is the respect for physiological birth, which supports the natural process unless there is a clear medical reason to intervene. This approach is rooted in the understanding that our bodies are designed to give birth and that breech birth is a variation of normal rather than an automatic cause for alarm. By trusting in the body’s natural ability, you and your provider can work together to allow the birth to unfold independently without unnecessary interventions.
Physiological breech birth involves careful monitoring and support but avoids intervening unless necessary. Skilled providers specializing in physiological breech techniques know how to assist the process without disrupting it. They understand breech birth’s unique movements and mechanics and will observe closely, stepping in only if a situation truly calls for it. This gentle approach respects the intricate processes of birth, often resulting in a smoother experience and reducing the likelihood of complications. For many women, this approach aligns more with their desire for a low-intervention birth that celebrates their body’s innate ability to bring their baby into the world.
By embracing these values, you can make informed and empowering decisions about your breech birth. Breech birth care, guided by autonomy, compassion, cultural respect, and trust in physiology, offers a pathway that honors your body and your choices. By understanding these principles, you can confidently approach your breech birth, knowing that you have options, support, and the freedom to choose the birth experience that resonates with you.
Evidence and Safety in Vaginal Breech Birth
When it comes to breech birth, the conversation around safety is central. Understandably, hearing that your baby is breech may lead to fears and concerns, as you’ve likely encountered information suggesting that a cesarean section is the “safer” route. However, this perspective doesn’t always provide a full picture, especially for those with access to a skilled provider trained specifically in breech births. Research and expert opinions reveal that with the right support, a vaginal breech birth can be a safe and empowering option, often with outcomes comparable to a head-down birth.
Your Right to Choose
The right to choose your preferred mode of birth, even with a breech presentation, is widely supported by many obstetric and midwifery organizations. For example, the American College of Obstetricians and Gynecologists (ACOG) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) both recognize a woman’s right to decide on a vaginal birth after informed counseling about the risks and benefits of each option. The emphasis here is on autonomy—meaning that even if a provider recommends a cesarean, you have the right to pursue a vaginal birth with the right support in place. This choice allows you to explore options that resonate with your values and goals for your birth experience.
Provider Experience Matters
The experience and training of your provider play a crucial role in the success and safety of vaginal breech birth. Studies have consistently shown that providers with specialized training in breech techniques achieve high success rates with minimal complications. For example, a study published in Acta Obstetricia et Gynecologica Scandinavica found that vaginal breech births attended by experienced providers had outcomes comparable to those of head-down vaginal births. Skilled breech practitioners understand the nuances of breech birth, including monitoring fetal positioning and timing interventions appropriately. This expertise leads to a higher likelihood of achieving a vaginal birth with fewer complications, offering a path that aligns with both safety and autonomy.
Revised Selection Criteria for Breech Birth
Traditional guidelines often impose strict selection criteria for vaginal breech births, ruling out this option for many women based on factors like the baby’s size, maternal age, or whether it’s a first pregnancy. However, many experienced breech providers advocate for broader selection criteria. Evidence suggests that many women, including those having their first baby or with a baby in a non-standard breech position, can still safely attempt a vaginal birth. A study published in BJOG: An International Journal of Obstetrics and Gynaecology supports this approach, indicating that with skilled providers, many factors once considered risks (such as first-time motherhood or specific breech positions) do not inherently increase the likelihood of complications in vaginal breech birth. This updated approach encourages a focus on the provider’s skill rather than arbitrary criteria, enabling more women to make informed decisions that align with their preferences.
Positioning and Movement for Optimal Outcomes
Positioning during labor plays an essential role in facilitating a safe breech birth. Upright, forward-leaning positions have been shown to shorten the second stage of labor, reducing the risk of maternal and neonatal injuries. A Birth: Issues in Perinatal Care study highlights that allowing the mother freedom to move and adopt upright positions can improve outcomes in breech birth. Upright positions help the baby navigate the birth canal more effectively, reducing pressure on the mother’s pelvis and enabling gravity to assist the process. Many women instinctively find comfort in these positions, which allow them to feel more in control and physically supported during birth. Moreover, a physiological approach encouraging natural movement can result in fewer medical interventions, providing a more holistic and low-intervention birth experience.
Benefits of a Natural, Low-Intervention Breech Birth
With skilled support, a vaginal breech birth can provide an empowering, natural experience that aligns with a woman’s values and birth preferences. Allowing the birth process to unfold naturally respects the physiological design of both mother and baby, minimizing the need for interventions unless medically necessary. Studies suggest that when experienced providers respect and follow physiological birth practices, the outcomes for breech births can be on par with head-down births, offering a safe option that allows mothers to avoid the risks associated with major surgery. This approach enables women to feel active in their birth process, experiencing childbirth as an instinctive, powerful journey.
Understanding the safety and evidence surrounding breech birth can help alleviate fear and uncertainty. Knowing that a vaginal breech birth is possible—and often safe—when attended by a trained provider allows you to consider this path with confidence. With growing support for autonomy, updated criteria, and the benefits of natural birthing positions, the option of a vaginal breech birth is more accessible and validated than ever, empowering you to make a choice that feels right for both you and your baby.
Debunking Myths About Breech Birth
Breech birth is often surrounded by misconceptions that can cause unnecessary fear and prevent women from exploring all their options. Understanding the truth behind these myths can empower you to make more informed choices about your birth. Here, we’ll break down some of the most common myths and examine the evidence.
Myth 1: Breech Birth is Inherently Dangerous and Should Always be a Cesarean
Breech birth is often labeled as “inherently dangerous,” leading many to believe that a cesarean section is the only safe option. While breech presentations have unique considerations, they’re not automatically risky. Studies support that, with a trained and experienced provider, vaginal breech birth can be a safe option. Research published in Acta Obstetricia et Gynecologica Scandinavica indicates that when attended by skilled providers, the outcomes of vaginal breech births can be comparable to head-down births without a higher risk of complications. Access to a vaginal breech birth often depends on the provider’s training, as well as the support given to the mother. Breech birth can be managed safely through careful observation, respectful support, and minimal intervention, rather than a blanket recommendation for cesarean.
Myth 2: Vaginal Breech Birth Requires Extensive Intervention
A common belief is that vaginal breech birth demands significant intervention, but the reality is often the opposite. Many experienced breech providers advocate for a “hands-off” or “do not touch” approach during vaginal breech birth. Research suggests that excessive handling or intervention during a breech birth can disrupt the baby’s natural movements, potentially increasing the risk of complications. According to a review in the Journal of Maternal-Fetal & Neonatal Medicine, allowing the baby to move through the birth canal with minimal interference often leads to safer, smoother births. Skilled providers use their expertise to observe and only intervene when necessary, letting the physiological process unfold naturally.
Myth 3: Only Experienced Mothers Should Attempt a Vaginal Breech Birth
Another common myth is that only women who have had previous vaginal births are good candidates for a vaginal breech delivery. This assumption can unnecessarily limit options for first-time mothers or women without prior vaginal births. Studies show that success rates for vaginal breech births aren’t solely dependent on maternal history but rather on the provider’s experience and skill level. A study in BJOG: An International Journal of Obstetrics and Gynaecology highlights that even first-time mothers can have safe, successful vaginal breech births with an experienced provider. A restriction that limits vaginal breech birth to only certain women may lead to unnecessary cesareans. The most important factors are having a supportive provider, access to a safe setting, and the freedom to allow the birth to progress naturally.
Myth 4: Breech Babies are Always at Risk for Health Issues After Birth
Many women worry that their breech baby might face health challenges simply because of their position at birth. While breech positioning can present certain physical adjustments for the baby, such as temporary swelling or bruising, these effects are usually short-lived. Research indicates that long-term health outcomes for breech babies born vaginally are generally comparable to those born in the head-down position. A 2018 review published in Neonatology found that with proper monitoring and skilled care during a breech birth, both short-term and long-term health outcomes for breech babies are positive, often with no lasting complications related to their presentation at birth.
Myth 5: Breech Births Should Always Be Delivered in a Hospital Setting
Another misconception is that breech births must take place in a hospital for safety reasons. While some women may feel most comfortable in a hospital, others choose home or birth center settings with trained breech providers. A study from the Midwifery Journal found that planned vaginal breech births, even outside hospital settings, can be safe when attended by skilled providers. This flexibility empowers women to choose the birth environment that aligns with their values, personal comfort, and trust in their care team. The key factor is not the location itself but the skill and preparedness of the provider, along with access to support in case of emergencies.
Understanding these myths and misleading statements about breech birth makes you feel more informed and empowered. Your choice to pursue a vaginal breech birth, if that’s what feels right to you, should be supported by your care team with respect, skill, and up-to-date information on best practices.
Choosing What’s Right for You: Navigating Breech Birth Options
When facing a decision about your breech baby, remember that you have options. This is your birth, your body, and your baby; there is no one-size-fits-all answer. Making an informed choice means looking at the available information and reflecting on what feels right for you.
- Get Informed: Talk openly with your provider about the risks and benefits of both vaginal breech birth and cesarean. Ask about their experience with breech births, their approach to physiological birth, and how they support individual preferences. The safety of breech birth can often depend on the provider’s skill and commitment to honoring the birth process, so knowing their background and stance on breech births can be a valuable part of your decision-making.
- Consider Your Values: For many women, birth is more than a medical event; it’s a significant life experience with emotional, cultural, or spiritual meaning. Finding a provider who respects and supports your choices is essential if you value a low-intervention approach and want a birth experience that aligns with these values. Choose someone who will stand by your side, honor your preferences, and allow you to feel fully in control of your birthing journey.
- Weigh the Evidence: Research supports that with a skilled provider, vaginal breech birth can be a safe alternative to cesarean for many women. Take time to understand the research and statistics, and explore what the numbers mean for you and your baby. Asking thoughtful questions and seeking a provider willing to offer honest, evidence-based insights can help you feel secure in your choice.
- Trust Your Body and Your Baby: Breech birth is still just a variation of normal birth, and with the proper support, your body and baby can work together naturally. When women are encouraged to move freely, listen to their bodies, and follow their instincts, birth can unfold in powerful and transformative ways. Trusting your body, embracing your strength, and leaning on skilled support can allow a vaginal breech birth to be an experience filled with confidence and empowerment.
Your decision about a breech birth is deeply personal. Trust yourself to make the choice that resonates with you and respects your body, instincts, and vision of this birth.
Moving Forward with Confidence
Learning that your baby is breech can be unsettling, especially with so much misinformation surrounding this type of birth. Much of the uncertainty and fear around breech birth comes from the simple fact that most healthcare providers today receive little if any, training or hands-on experience with vaginal breech delivery. For many in the medical field, breech birth is a mysterious terrain, and we often fear what we don’t fully understand.
In my practice, I’ve had the honor of supporting dozens of mothers through their breech birth journeys. It’s been inspiring and enlightening to see how breech birth can unfold naturally and confidently with the right knowledge and careful guidance. Every breech birth I’ve attended has been a unique experience, reflecting each mother’s personal strength, values, and birth vision. Time and time again, I’ve seen that when a woman feels informed and supported, her birth can be a positive, empowered experience—regardless of the baby’s position.
As a mother, I believe you deserve access to accurate information and compassionate, skilled care. In my practice, I work closely with each mother to explore the safest, most personalized path forward. Breech birth doesn’t mean you have to let go of your birth goals or submit to a standard approach that may not feel right for you. By focusing on your health, comfort, and the wisdom of physiological birth, we can navigate this journey with confidence and clarity.
With knowledge, a supportive team, and a provider who respects your choices, a breech birth can be both safe and empowering. If you feel called to explore this journey, know that there are options that align with a holistic approach, honoring your vision for a meaningful, fulfilling birth experience.
Additional Reading
For more information on breech birth options and safety:
- Breech Without Borders Best Practice Guidelines
- Breech Birth by Benna Waites
- Breech Birth: Causes & What To Do If Baby Is In A Breech Position by Cathrine Petrucci
Note: Full disclosure: I earn a small (very small) commission on any links that take you to Amazon.
Jaelin Stickels, CNM, WHNP, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of experience, Jaelin has had the privilege of helping several hundred women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area. Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process. Jaelin is finishing her doctorate and looking forward to being Dr. Jaelin in early 2025.
Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.
Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.
Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX