When is it better to have a cesarean section in breech position?

If termination of pregnancy is planned by cesarean section, breech delivery is usually chosen around 39 weeks of gestation, about 7 days before the due date. An emergency cesarean section is required before 39 weeks if there is a rupture of the membranes or contractions, or if there are other complications and complications that prevent the pregnancy from continuing. The normal fetal position is cephalic, where the head of the fetus is located below the uterus and the head comes out first. The breech position is when the breech or foot is below the uterus and the head is above the uterus, with the breech being delivered first. Since the circumference of the breech is smaller than the circumference of the head, it may happen that the head cannot be delivered after the breech can be delivered, and if the delivery of the head takes too long, intrauterine distress and neonatal asphyxia may occur. During delivery, complications such as clavicle fracture, brachial plexus injury, and sternocleidomastoid muscle injury may also occur. In addition, not all breech deliveries require a cesarean section. It is necessary to check whether the mother is a perinatal or a primiparous woman, and to perform an ultrasound examination to determine whether the fetus is single breech first or fully breech first, and then the doctor will choose the delivery method and whether to perform an external breech inversion to correct the fetal position according to the specific situation and the mother’s wishes. The position of the fetus in the uterus is usually fixed after 30 weeks. If the ultrasound indicates that the fetus is in breech position at around 30 weeks, the pregnant woman can try to correct the fetal position by lying on her knees and chest or by moxibustion at the Zhiyin point. However, if abnormal fetal movement and slow fetal heartbeat occur during the correction process, it is not recommended to continue to do so. Around 37 weeks of pregnancy, if the pregnant woman herself has the desire to give birth vaginally and her condition is also suitable, she can be tried by a doctor to perform external breech inversion.