In breech births, although a Cesarean is safer for the child than vaginal birth, the mother runs a greater risk of complications. One out of 80 children born vaginally in a breech presentation dies or has serious problems after birth; this number is only 1 out of approximately 600 when a Cesarean is performed. This is the conclusion reached by gynecologist Christine Rietberg of UMC Utrecht using data from the Netherlands Perinatal Registry. She analyzed all breech deliveries between 1995 and 2004, a total of 45,000 breech births.
However, Rietberg does not recommend a Cesarean for all breech births. The scar that forms in the uterus after the operation can rupture during a subsequent delivery. There is also a greater chance that the placenta will become imbedded in the scar. Although the chance of this happening is very small, Rietberg argues it is still something that should be taken into account.
She believes that pregnant women with breech presentations should be provided with proper information. “Vaginal delivery is probably better for a young woman’s first pregnancy, someone who might want to have more children. But a 39-year-old woman who had a very hard time getting pregnant would do well to consider a Cesarean.”
Rietberg’s research could bring to an end a long-running debate among gynecologists. A large international study done in 2000 has already shown that Cesareans are safer in pregnancies with breech presentations – now Rietberg has shown this is also true in the Netherlands. Right now, in 80 percent of breech births gynecologists decide to perform Cesareans, and parents have a considerable say in this.
Christine Rietberg will receive her PhD from Utrecht University on October 31.
More information:
UMC Utrecht, Internal- and External Communication
Poppy Soen en Linda Minnen, tel. 088 75 574 83