Breech birth: an unusual normal

Over the last decade, there has been a loss in confidence and eroded skills due to the near universal policy of advising caesarean section in the wake of the Term Breech trial (Hannah et al 2000). Breech birth has been increasingly viewed as a complication, and management of the breech presenting baby at term has shifted firmly into the realm of obstetric practice in most parts of the UK. Small pockets of exception remain, among NHS and independent midwives who have maintained their skills with breech birth and are sought out by women denied the choice of a vaginal birth elsewhere. With continued focus on consumer choice, women led care and increasing normality, we urgently need to address the issue of how the NHS can safely provide the option of normal breech birth before these skills are permanently lost. This article suggests ways midwives may play a role within the NHS in ensuring women have a choice to birth their breech babies normally, in the safest possible way.