What is a breech birth and how can it lead to birth injury?
What Is a Breech Birth?
A breech birth occurs when a baby is positioned in the uterus with the buttocks or feet aimed at the birth canal rather than the head. In a typical delivery, the baby descends head-first (called the “vertex” or “cephalic” position). When the baby is positioned feet- or bottom-first, it is considered a breech presentation — and it carries increased risks for both the mother and the baby during delivery.
Types of Breech Presentation
There are several variations of breech positioning:
- Frank breech: The baby’s buttocks are aimed at the birth canal, with both legs extended upward toward the head — the most common type
- Complete breech: The baby’s buttocks are down, with knees bent and feet near the buttocks
- Footling breech: One or both feet are positioned to enter the birth canal first — the highest-risk type
How Is Breech Presentation Managed?
Breech presentation is typically identified through ultrasound in the weeks before the due date. When a breech presentation is detected, medical providers have several options:
- External Cephalic Version (ECV): A procedure performed around 36–37 weeks in which a physician attempts to manually rotate the baby to a head-down position through gentle pressure on the mother’s abdomen. It is successful in roughly half of cases and carries some risks.
- Planned cesarean section (C-section): The most common management approach in the United States for breech presentation. Because vaginal breech delivery carries significantly higher risks of complication, most practitioners recommend cesarean delivery when the baby cannot be turned.
- Attempted vaginal breech delivery: Rarely performed in modern obstetric practice in the United States and only considered in very specific circumstances with providers experienced in breech delivery.
What Injuries Can Occur During a Breech Birth?
When breech delivery is mismanaged — or when a provider fails to identify the breech position and proceeds with a vaginal delivery unprepared — serious birth injuries can result, including:
- Umbilical cord prolapse, which can cut off oxygen to the baby
- Head entrapment, which can cause brain injury from oxygen deprivation
- Brachial plexus injuries from excessive traction during delivery
- Fractures of the arm, leg, or clavicle
- Hypoxic-ischemic encephalopathy (brain injury from lack of oxygen)
Breech Births and Medical Malpractice in Pennsylvania
A healthcare provider’s failure to identify a breech presentation, failure to recommend a timely cesarean section, or improper management of a breech delivery may constitute medical malpractice if it causes harm to the baby or mother. Pennsylvania law allows families who have suffered birth injuries to pursue claims for compensation when those injuries were caused by negligent medical care. If your child was injured during a breech delivery, consulting with an experienced Pennsylvania birth injury attorney can help you understand whether the standard of care was met and what options your family may have.
