Breech delivery--what influences on the mother's choice?

Abstract

Objective: To investigate factors influencing the mother's choice of delivery mode when vaginal breech delivery is considered possible and safe.

Design: Retrospective study.

Setting: University Hospital.

Population: Singleton, term pregnancies with breech presentation were included, n = 390.

Methods: Information was collected from patient records from January 2006 to December 2010. A questionnaire was sent to those 293 women in whom vaginal breech delivery was considered possible and safe.

Main outcome measures: Patient characteristics by choice of delivery mode.

Results: Women who were selected for vaginal breech delivery (n = 187) were younger, more often nulliparous and gave birth to smaller babies. Women who requested a cesarean section (n = 112) became more worried when the breech presentation was diagnosed. They had a more negative initial view on breech presentation, more often took additional advice from nonprofessionals and trusted them more. Women who requested cesarean section reported a positive birth experience more frequently than women who were selected for vaginal delivery, whether ending as vaginal or emergency cesarean delivery. Women in both groups searched web-based information about breech delivery. We found no differences between the sources of information used.

Conclusions: Younger, nulliparous women with smaller babies trusted and listened more to professional advice and were more prone to choose vaginal delivery. Women who requested a cesarean section were more worried and had a more negative initial view on breech presentation. Both groups sought web-based information equally.

Keywords: Breech; cesarean section; delivery; term-pregnancy; vaginal.