Breech birth is coming back to Canada and could to a hospital near you

There are different interpretations of breech studies in general and the Term Breech Trial in particular, a much publicized study that suggested caesarean section to be safer for breech delivery for the neonate than vaginal delivery. It is not surprising that different countries, different cultures, and different professions have arrived at a multitude of protocols prenatally and during labour for women presenting breech. In the late nineties, a number of major centres in Europe declined the offer to enter the Canadian-based Term Breech Trial because of concerns about the methodology and/or because they were pursuing research in their own centres. Israel entered into the trial, but the Tel Aviv centre realized the trial should be withdrawn once the conclusions of the 2-year follow-up, with differing conclusions, were published. The studies from Norway, Germany, France and Belgium do not find any significant advantage to performing cesarean section for term breech delivery, similar to the 2-year follow up. Finally, a unit in Frankfurt is bringing back an ancient way of doing breech births—on the hands and knees or in an upright position, which virtually eliminates the need for forceps. With the aid of the British midwives, the mechanisms of the breech in the upright and hands and knees position become more understandable. This presentation will put all of this research together and show videos of the hands and knees position.