The Complications of Breech Deliveries

It’s no secret that carrying and delivering a baby is a miracle, even by today’s standards. Having a healthy and safe delivery is every parent’s dream. Complications are not uncommon, though, and can often be treated and dealt with in a safe manner.

One such complication includes breech deliveries, and while breech deliveries result in plenty of healthy babies being born, there are risks to the mother and the child. If the obstetrician does not make you aware that you are on course for a breech birth, or they do not offer alternatives, this could ultimately lead to injuries or health conditions that could have been avoided if another path had been provided to you. In this case, the mother-to-be could file a medical malpractice claim against the care provider.

What is a breech delivery?

A conventional delivery happens when, during a vaginal delivery, the head of the baby is facing downward so that the head is birthed first. This is usually the safest way to deliver a baby. A breech delivery is when the opposite is true: the baby’s head is pointed upwards inside the uterus, and the feet are downward and in position to be delivered first.

A fetus being in the breech position during pregnancy is relatively common early on in the pregnancy, but will generally gradually reposition to a head-first position. It is uncommon for the fetus to still be in a breech position after 37 weeks, but not unheard of; according to the Cleveland Clinic, “Breech babies account for about 3% to 4% of all full-term pregnancies.”

As vaginal breech deliveries can be complicated and risky, the obstetrician is likely to recommend a Cesarean birth be performed instead, where the baby is removed from the mother through a surgical incision made through the mother’s abdomen and uterus.

What increases the chance of a breech delivery?

While there are factors that increase the likelihood of the infant being born breech, there is not always a reason. The Cleveland Clinic gives the possible causes of a baby being born breech as follows:

• You are expecting multiples (twins or more). This makes it harder for each baby to get into the right position.
• There is too much or too little amniotic fluid.
• The uterus is not normal in shape or has abnormal growths such as fibroids. Most of the time, the uterus is shaped like an upside-down pear. If it’s shaped differently, there might not be enough room for a full-grown baby to move into position.
• The placenta covers all or part of the cervix (a condition called placenta previa).
• The baby is preterm. This means they are less than 37 weeks gestation and may not have turned to a head-first position.
• Your baby has a birth defect that causes them to not turn head-down.

What is critical is identifying that the fetus has presented in a breech position, and planning with the care provider how to best go forward with the delivery.

What are the complications of a breech delivery?

While some breech deliveries occur without issues, as stated earlier, there are several complications that can occur while undergoing a breech delivery. Some of these complications can cause lifelong conditions and effects on the infant.

These complications include:

• Broken or dislocated limbs. When a baby is delivered head first, all of its limbs are pressed against the body, making them safe from being pushed into odd angles. In a breech position, the ends of the limbs are facing outward, and may be bent crookedly when leaving the vaginal canal, also possibly resulting in limbs being pulled awkwardly.
• Problems with the umbilical cord. During a breech delivery, the umbilical cord can be twisted or flattened. As the umbilical cord is responsible for bringing nutrients and oxygenated blood to the baby, any obstruction can lead to nerve or brain damage due to lack of oxygen.
• Turning the baby during delivery. While turning the baby to be in the correct position is a way to turn the breech delivery into a conventional delivery, it can also lead to complications. Usually done at 37 weeks, external cephalic version (EVC) “involves placing hands on your abdomen and applying firm pressure to turn your baby to a head-down position while your baby is still in your uterus.” While this is successful about 65% of the time, the complications include:
  • Premature labor.
  • Premature rupture of the amniotic sac.
  • Blood loss for either the mother or the baby.
  • Emergency C-section.
  • The baby might turn back to the breech position.

It is critical that the obstetrician keep you updated on the position of the fetus through physical examinations throughout your delivery. If by 37 weeks, the infant has not changed into the correct position, the doctor should provide you with options concerning how best to handle the delivery of your child.

Filing a medical malpractice suit for injuries caused by a breech delivery

Negligence amounts to medical malpractice. This is no different for obstetricians when providing medical care for a mother-to-be. These medical care providers need to be constantly checking in with their patient, asking questions about how they feel or if they think anything is off. They are also responsible for performing medical examinations and tests on the pregnant woman in order to best predict possible complications such as breech positioning of the baby. If the medical professional neglects to perform these tests or keep in contact with you, you can file a medical malpractice suit against them.

If prior to or during the delivery a cesarean section is not offered as an alternative to a breech delivery, assuming that a cesarean section is not too late to be performed, the obstetrician could be held liable for any birth injuries the child sustains.

Any pregnant woman should expect the best care possible from their healthcare provider. When such care is withheld or is neglected, the mother and the infant can suffer. During a breech delivery, there are several ways in which the mother and the child can sustain injury, or suffer long term conditions brought on by the negligence of their obstetrician.

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