Breech presentation at term Informed decision, options, breech delivery

The breech position is a variant of presentation, which occurs in ca. 3-6% of pregnancies at term. After prenatal counseling and shared decision-making, first an external cephalic version and thereafter a cesarean section (planned or at onset of labor) or a vaginal delivery from the breech position can be offered. At present a vaginal delivery is only possible and safe in specialized and designated departments. The quality of care is dependent on various factors: selection of a suitable candidate, wide experience of the involved obstetrician and midwives and written guidelines. An upright delivery position is advantageous in breech presentation and leads to a physiological spontaneous birth in approximately half of the cases. This article focuses on the management of breech presetation in uncomplicated pregnancy at term in the presence of a breech position.