How should you deliver a breech baby?

• A. Place the mother in a face down position with the pelvis elevated
• B. Keep the mother in a sitting position
• C. Position the mother on her side with hips neutral
• D. Place the mother in a supine position with legs apart

Answer: (A)

When a breech presentation is present, the important idea is to use gravity and posture to help the presenting part deliver first and to reduce the chance of the head becoming entrapped. Positioning the mother face down with the pelvis elevated aligns the birth canal to favor the breech moving downward and forward, which can make the delivery of the buttocks and legs easier before addressing the head. This setup also helps that the umbilical cord isn’t tightly squeezed as the breech comes through, giving better space and time to manage the infant once the body has delivered.

Other positions do not optimize gravity for breech progression and can increase the risk of complications such as cord compression or head entrapment, making them less suitable. In any breech situation, rapid transport and careful monitoring are essential, with cautious handling to avoid pulling on the presenting part.