Controversies: the mature breech should be delivered by elective cesarean section

The fetal hazards of vaginal breech delivery have been recognised for centuries. In recent years the increased safety of Cesarean delivery has prompted a steady rise in its use for the delivery of the term breech fetus. In many maternity units more than 90% of breech babies are delivered in this way. In contrast some obstetricians argue that with appropriate selection criteria, safe, selective, vaginal breech delivery is possible. This argument is not supported by population studies, which indicate that perinatal mortality and morbidity rates associated with attempts at vaginal breech delivery are between 1-2%.