Respecting the Choices of Women
Vaginal breech birth was practically banned following a significant international research study in 2000. This study, the "Term Breech Trial" or TBT, appeared to prove that caesarean section was substantially safer for the delivery of all breech babies. The trial was highly criticized, but many birth care providers took this opportunity to do what they wanted to do anyway - to stop offering vaginal breech birth to their clients, and to insist instead upon a surgical delivery. Very few centres continued to offer vaginal birth. To read the original TBT report, click here.
In addition to all the professional criticism, the TBT's own two year follow up negated the original results, suggesting that any difference in safety between vaginal and surgical birth of a breech baby is negligible - for both mother and child. Despite this evidence, many Birth Care Providers (BCPs) still avoid balanced informed choice discussions with their clients, denying them the opportunity to make an informed choice. Most frequently, it is flatly stated that surgical birth is the standard of care, and that is what is going to happen - regardless of that mother's individual circumstances. If vaginal birth is mentioned at all, it is brushed off as an inferior, unsafe choice. However, caesarean surgery, while it presents many advantages for the surgeon, has lifelong ramifications for the birthing woman and her family, including issues with subsequent pregnancies, secondary infertility, Vaginal Birth After Caesarean (VBAC) availability, and depression, not to mention a risk of death in childbirth increased threefold over vaginal birth.
Women should not be obliged to accept these serious risks as "standard of care" when clinical research clearly demonstrates that vaginal birth of a breech baby does not pose an increased level of risk. In addition, the recommendations of professional organizations such as The Society of Obstetricians and Gynecologists of Canada do not support automatic caesarean for breech. Yet, time and again, vaginal breech birth is presented as tremendously difficult and dangerous, and caesarean risks glossed over.
Our mission is to fill the gap in the informed choice discussion by offering women the evidence-based information and the vital support they need to make their own decisions.