Breech deliveries at Genesis Dnepr — a personalized approach.

What are breech births: delivery in which the fetus is positioned with its buttocks or feet toward the birth canal (breech presentation).

Who this may be relevant for:

women in whom a breech presentation is detected late in pregnancy.

Before labor it is important to discuss with your doctor assessment of the fetus’s position, possible management options for labor, individual indications for cesarean section, and pain relief/anaesthesia.

The decision on the mode of delivery is made individually based on the condition of the mother and baby, the specifics of the pregnancy, and the progress of labor.

The plan may change during labor in the interests of the mother’s and baby’s safety.

What this type of delivery means

Breech delivery is a mode of delivery in which the fetus is positioned with its buttocks or pelvis toward the birth canal. In practical terms, this means increased attention to the fetal position, the mother's condition, and the progress of labor. Before delivery, it is important to discuss management options, possible limitations, and pain relief with your doctor. Decisions are always made individually, taking the clinical situation into account.

Assessment of the fetal position and contraindications for attempting a vaginal birth
Planning labor management with consideration of possible conversion to cesarean section
Presence of an experienced team and readiness for urgent action if the condition worsens
Careful monitoring of the fetal condition and the dynamics of labor
Discussion of pain relief options and their impact on the course of labor
The possibility of vaginal birth is determined by strict clinical criteria and obstetric factors

It is important to remember that the final decision is made during monitoring and may change in the interest of the safety of the mother and baby. Discuss all questions with your doctor and midwife in advance to understand possible scenarios.

Who may be suitable for delivery with a breech presentation

This option is considered when, late in pregnancy, the fetus is in a breech (bottom‑first) position and a method of delivery must be chosen. It may not be appropriate for everyone and requires antenatal assessment of the mother and baby. It is important to discuss management options, partner participation, and pain relief in advance with the clinical team.

Discussing the birth scenario in advance and understanding possible management options
Partner presence at the birth, subject to agreement with the medical team
Discussing pain relief options and their potential impact on the course of labor
Pregnancy is progressing without major complications (to be assessed individually)
Desire to remain active and be able to change positions during labor
Considering previous birth experience when planning the current delivery
Need for a calmer, clearer birth plan to reduce anxiety

The final decision is made individually based on examination and the progress of labor. Discuss your preferences and possible scenarios at a consultation.

When this approach may be limited or unsuitable

An attempt at delivery in breech presentation is not always safe or feasible — sometimes the plan is changed during monitoring. Decisions are adjusted when subtle but serious signs appear in the mother or the baby, as well as due to organizational or infectious restrictions. Consider these situations as a normal part of medical decision-making.

Obstetric complications requiring urgent intervention or acceleration of delivery
Signs of fetal distress on intrapartum monitoring
Need for operative delivery (cesarean section) if the situation worsens
Medical contraindications to a specific type of analgesia or anesthesia that affect the plan
Infectious or organizational restrictions on the partner’s presence during labor
Unfavorable fetal position that complicates safe vaginal delivery
Maternal conditions in which safety takes priority over the initial plan

This is a normal medical process: the plan may change for the safety of the mother and baby. Discuss possible limitations in advance with your physician and midwife.

Who is involved in choosing the mode of delivery

The choice of delivery method is a joint decision between you and the medical team, based on the condition of the pregnancy and the current clinical situation. You have the right to voice your preferences and expectations, but the final decision is made on the basis of risk assessment and indications. In breech presentation, ultrasound results, the progress of labor, and the team's readiness for different scenarios are especially important. The plan is discussed in advance and may be adjusted during labor.

Patient preferences — stating preferences and questions about labor management
Physician and midwife assess the pregnancy, tests, ultrasound, and fetal condition
Consideration of previous birth experience and specific features of the pregnancy course
Anesthesiologist is involved when planning pain relief and choosing the method
Neonatologist participates when there is increased risk or to plan newborn care
Decision-making is team-based; the plan may change during labor for medical indications

Discuss your preferences and possible scenarios in advance so the team knows your expectations. If indications arise during labor, clinicians will adjust the plan in the interest of the mother’s and baby’s safety.

What to discuss with your doctor before childbirth

Prepare your questions in advance so that at the appointment you get a clear plan and understand possible scenarios. In the case of a breech presentation there are specific points that should be clarified separately. These questions will help align your preferences with medical indications.

What mode of delivery do you recommend in my situation?
Can my partner be present, and under what conditions?
What pain relief options are available and are there any contraindications?
How do previous deliveries or a cesarean section affect the delivery plan?
Are there any chronic conditions that need to be taken into account during labor?
Which ultrasound findings and test results are important for making a decision?
What is the plan of action if the condition worsens or the situation changes suddenly?
What should I take with me and which documents should I prepare in advance?
When is it best to go to the hospital after contractions or other signs begin?
What are the postpartum accommodations and what care is expected for the mother and baby?

Write down your questions and bring your examination results to the appointment. Remember that answers may be refined as the pregnancy progresses and during labor itself.

How preparation for childbirth proceeds with a breech presentation

Preparation for the chosen mode of delivery is a stepwise process of assessment and planning. With a breech presentation, attention is paid to clarifying the fetal position and the team's readiness for different scenarios. It is important to discuss in advance which examinations and interventions will be required.

Consultation with an obstetrician-gynecologist to assess the fetal position and delivery options
Review of the maternity record, ultrasound findings, and required tests
Discussion of the birth plan, including criteria for vaginal delivery and cesarean section
Consultation with an anesthesiologist if needed and discussion of pain relief options
Gestational-age-appropriate examinations to confirm readiness for the chosen delivery format
Preparing the partner: role during labor and compliance with the hospital’s rules
Familiarization with documents and administrative procedures when being admitted to the maternity hospital
Preparing a tentative list of items to bring and discussing when to arrive at the clinic

Preparation helps coordinate the team's actions and reduce uncertainty, but does not guarantee that the chosen scenario will be possible. Discuss details at a consultation to be ready for different options.

How labor proceeds in breech presentation

Labor in breech presentation is managed more carefully and in a controlled way, taking into account the fetal position and the team's preparedness for possible scenarios. Upon admission, the mother's and fetus's conditions are assessed, pain relief options and an action plan are discussed. During labor, the priority is the safety of the mother and baby, so the plan may be adjusted as the process unfolds.

Admission to the clinic, registration, and an initial examination by the medical team
Assessment of the fetal position and readiness for labor by the obstetrician and midwife
Monitoring of contractions and the progress of labor
Fetal monitoring to detect any changes in a timely manner
Discussion of pain relief and, if necessary, consultation with an anesthesiologist
Team-managed labor with readiness to involve a neonatologist if indicated
Pushing stage (second stage of labor) with support for the mother and monitoring of labor dynamics
Birth of the baby with particular attention to the sequence and safety of actions
Initial examination of the newborn and observation of the mother during the first hours after delivery

This outline gives an idea of a typical course of labor, but specifics depend on your individual situation.

Discuss expectations and possible changes to the plan in advance with your care team.

Pain relief during labor with breech presentation

Pain relief is discussed in advance during prenatal consultations and confirmed upon admission to the maternity hospital. Genesis Dnepr offers standard methods that are selected based on the condition of the mother and the baby. With breech presentation it is especially important to agree on possible options and have a backup plan in case circumstances change during labor.

Discussion of pain relief at the prenatal visit and upon admission to the maternity hospital
Anesthesiologist consultation when planning an epidural or other anesthesia
Assessment of contraindications and individual factors before choosing a method
Choice of method depends on the condition of the mother, the fetus, and the progress of labor
Possibility to change the decision during labor if indications arise
Limitations: some medical conditions may exclude specific methods
Monitoring of the mother’s and baby’s condition while analgesia is being used

Discuss your expectations and concerns in advance so the team knows your preferences and options. The final decision is made jointly with the anesthesiologist and the obstetric team in the interest of safety.

Monitoring and safety during breech delivery

Safety is the priority in any mode of delivery, including breech presentation. During labor the team continuously assesses the condition of the mother and baby and responds promptly to changes. Monitoring is a routine, prearranged part of the process, not a sign of an inevitable problem.

Assessment of the mother’s condition by the doctor and midwife on admission and during labor
Monitoring of the fetal heart rate using devices and, if necessary, cardiotocography (CTG)
Tracking contraction patterns and the progress of labor
Availability of an anesthesiologist for consultation and emergency support if needed
Preparation of a neonatologist to receive the baby in higher‑risk cases
Readiness of the team to quickly change the delivery approach for safety
Regular verbal discussions with the patient about her condition and next steps

This approach helps the team respond promptly to any changes and keeps the focus on the safety of both mother and baby. Discuss with your team how monitoring will be organized in your case.

If labor doesn't go as planned

A birth plan is a guideline that may be adjusted as events unfold for safety. In cases of breech presentation, changes to the plan are a normal part of labor management and are intended to protect the mother and baby. The team will inform you and, whenever possible, agree on actions in advance.

Your partner may be asked to leave the delivery room for medical or infection-control reasons
A vaginal birth may require stimulation/augmentation or conversion to cesarean section
Epidural anesthesia may be contraindicated and therefore unavailable
Upright positions may be changed to horizontal positions for safety reasons
A low-intervention plan may be altered if there is a risk to the baby
The team may speed up delivery or perform an emergency cesarean section
Changes and their reasons will be discussed with you, whenever possible, before action is taken
Analgesia and newborn care will be adjusted as needed

Such changes are not a failure but an adaptation of the plan in the interest of the mother’s and baby’s safety. Discuss possible scenarios in advance to better understand what to expect.

Possible risks and limitations when choosing the mode of delivery

Every mode of delivery has its limitations, and this is especially important to consider in breech presentation. Risks depend on the condition of the mother, the baby, and the specific course of the pregnancy, not only on the chosen scenario. Discussing limitations in advance helps prepare for possible changes to the plan.

Limitations of the chosen mode of delivery depend on the condition of the mother, the fetus, and the course of the pregnancy
Surgical intervention may become necessary during labor
Some methods of pain relief may be contraindicated with certain comorbidities
Infectious or organizational restrictions may sometimes affect the possibility of partner presence during labor
Relying on others’ experience does not replace an individual assessment of your situation
Clarifying the criteria for changing the plan with your doctor helps you understand possible scenarios and next steps

Take these limitations into account when discussing your birth plan with the team.

The safety of the mother and baby is always the priority.

What happens immediately after birth

Immediately after the baby is born, the team follows standard steps to assess and support the mother and newborn. At Genesis Dnepr, CTG (cardiotocography) and a neonatal examination are always performed during delivery. The first minutes and hours are dedicated to contact, assessment of condition, and arranging further care.

First skin-to-skin contact and assistance with the first latch
Examination of the newborn by a neonatologist and a quick assessment of condition (always performed at the clinic)
Monitoring the mother's condition, checking blood loss and overall well-being
Performing CTG and monitoring the heart rate — a standard part of observation (always performed at the clinic)
Transfer to the postpartum ward and organizing care for mother and baby
Feeding support and brief guidance on care during the first hours
Observation in the first hours and readiness to quickly adjust the plan if necessary

The sequence of procedures may vary depending on the situation and condition. Discuss in advance with the team what is important to you in the first hours after delivery.

Role of the doctor and the birth team

Labor is managed by a team of specialists, each performing their role to ensure the safety of the mother and baby. The doctor and obstetrician assess the condition, monitor the progress of labor, and make clinical decisions. If necessary, the team involves an anesthesiologist, neonatologist, and the operating room crew.

Assessment of maternal and fetal risk to choose a safe management strategy
Monitoring the dynamics of labor and timely adjustment of the plan
Clinical decisions made by the doctor and obstetrician, explained to the patient
Involving an anesthesiologist when planning pain relief and if emergency assistance is needed
The midwife’s work supporting the mother, monitoring labor, and assisting during pushing
Preparing the neonatologist to receive the baby and perform the initial examination
Readiness of the operating team for emergency delivery when indicated

Teamwork is aimed at ensuring safety during childbirth, but it does not eliminate the possibility of complications.

Don’t hesitate to ask questions to understand what is happening and why certain decisions are being made.

How this format benefits the patient

The approach to labor in breech presentation is organized so that you understand in advance the main stages and possible scenarios. This allows you to discuss your preferences, reduce uncertainty, and plan support during labor.

It is important to remember that the final decision always depends on the clinical situation.

A clear birth plan discussed with the team before admission
The opportunity to state and agree on personal preferences in advance
Reduced uncertainty through clear criteria and stages of management
The ability to choose and arrange for a specific doctor to be present
Partner presence by agreement and in line with medical requirements
Availability of pain-relief options, taking into account indications and contraindications
Continuous monitoring of mother and baby and the team’s readiness for different scenarios
Organizational support and information about next steps after delivery

These benefits help you feel more confident and better prepared for labor. Discuss specific expectations and details with your team in advance.

What to expect at a pre-delivery consultation

A consultation is a structured meeting for a joint assessment of your condition and the development of a safe delivery plan. In cases of breech presentation it is important to review the pregnancy history, test results, and to discuss your preferences and any possible limitations. At the appointment the team explains which factors influence the choice of delivery mode and what steps to expect next. Sometimes several meetings or additional tests are needed to clarify the decision.

Taking medical history: course of the pregnancy, chronic conditions, and previous deliveries
Reviewing the maternity record and all available examination results
Reviewing current ultrasounds and laboratory data to assess risks
Discussing your preferences for labour management and partner presence
Explaining possible restrictions and the criteria for switching to a different delivery mode
Helping choose a safe delivery mode together with your doctor and midwife
If needed, consultation with an anesthesiologist or neonatologist to clarify details
Recommendations on when to go to the clinic and answers to your important questions

Bring your maternity record and a list of questions to the appointment so you can discuss everything in detail. Decisions may be refined as labour approaches and during ongoing monitoring.

Please note that online consultations are available for patients from other cities. We often receive requests from Zaporizhzhia, Pavlohrad, Kamenskoye (Dniprodzerzhinsk), Novomoskovsk (Samar), Kryvyi Rih, Nikopol, Marganets, Sinelnikovo, Pokrov, Zhovti Vody, and other cities.

Preparing for admission to the maternity hospital

Prepare in advance so that when you are admitted to the maternity hospital everything is at hand and clear for the team. If you have a breech presentation, check at your consultation whether additional documents or examinations are needed. Discuss medication questions and an approximate arrival time at the clinic with your doctor in advance.

Passport/ID, insurance policy, and any necessary medical documents
Maternity record (pregnancy medical record) with prenatal care notes
Up-to-date test results and the latest ultrasound reports
A list of regularly taken medications, marked to discuss with the doctor
A basic set of essentials for the mother (no detailed inventory)
Basic newborn supplies, agreed with the care team
Items and documents for the partner, if their presence is planned

Pack everything in advance and take a list of questions for admission. Ask your doctor when it’s best to travel to the clinic and what specific details to consider on admission.

Maternity Department Conditions — Genesis Dnepr

The maternity department is organized to ensure safe labor management and postpartum observation. In cases of breech presentation, special attention is given to the team's readiness and equipment for different scenarios. Organizational questions and requirements for partner presence can be discussed before admission.

Labor rooms for admission and childbirth with necessary equipment
Postpartum wards for recovery and monitoring of mother and baby
Rooming-in of mother and baby when there are no medical contraindications
A neonatologist is available for reception and initial examination of the newborn (always performed)
An anesthesiologist is available and can provide consultation about pain relief when indicated
Partner-supported births are possible if medical and organizational requirements are met
Teamwork between physician and midwife, with prompt involvement of other specialists if necessary
The possibility to arrange individual accompaniment and organizational details before admission

Please clarify any details and your wishes at the prenatal consultation. This will help the team take your expectations into account and respond promptly if the care plan changes.

When to seek urgent medical attention

If alarming symptoms appear, do not wait for a scheduled appointment — seek care immediately. In cases of breech presentation, some changes require urgent assessment by the care team. Below are signs that mean you should go to the maternity hospital or call your doctor right away.

Bloody or heavy vaginal discharge
Your waters have broken or the amniotic fluid has noticeably changed
Regular contractions that intensify and do not stop
Sharp, intense, or persistent abdominal pain
A significant decrease or absence of fetal movements
A sudden and marked increase in blood pressure
Severe headache or sudden visual disturbances
Fever, chills, or other signs of infection
Marked weakness, confusion, or a near-fainting episode
Any sudden change in how you feel that causes serious concern

If you experience one or more of these symptoms, contact your clinic or go to the maternity hospital. Prompt assessment helps ensure timely and safe decisions for you and your baby.

Frequently Asked Questions

Question: Can the mode of delivery be chosen in advance for breech presentation?

Answer: You can discuss your preferred mode of delivery in advance, but the final decision depends on clinical assessment and may be adjusted.

Question: Is this type of delivery suitable for everyone?

Answer: No — suitability depends on the condition of the mother and the fetus; the doctor determines appropriateness after examination.

Question: Can the plan change during labor?

Answer: Yes — the plan may change for medical reasons to ensure the safety of the mother and baby.

Question: Can the delivery format be discussed before labor begins?

Answer: Yes — options, criteria, and possible scenarios are discussed at a prenatal/antenatal consultation.

Question: Can I have my partner present during this type of delivery?

Answer: In most cases a partner’s presence is possible, but this is coordinated with the team and depends on medical and organizational conditions.

Question: Is epidural anesthesia possible with breech presentation?

Answer: Pain management is discussed with the anesthesiologist; an epidural may be an option, but the decision depends on indications and contraindications.

Question: Who decides which anesthesia to use?

Answer: The decision is made jointly by you, the anesthesiologist, and the obstetric team, taking into account the clinical situation and indications.

Question: What if the chosen anesthesia is not suitable?

Answer: The anesthesiologist will offer alternatives or adjust the approach during labor in the interest of safety.

Question: When is it best to go to the hospital?

Answer: You should go when contractions become regular, the waters break, there is vaginal bleeding, or other worrying symptoms occur; exact recommendations should be discussed with your doctor.

Question: What should I bring to the maternity hospital?

Answer: Bring identification, your antenatal/maternity record, test results, a list of regular medications, and basic personal items — coordinate details with the clinic.

Question: Do I need my antenatal record and other documents?

Answer: Yes — the antenatal record and identification documents help the team quickly assess the pregnancy and manage admission.

Question: Can I come with already completed tests and examinations?

Answer: Yes — bring all current results and ultrasound scans; this speeds up and clarifies decision-making.

Question: What happens if a cesarean section is needed?

Answer: The team will explain the reason and the plan of action; when indicated, an operative delivery (cesarean) is performed for safety.

Question: How long is the usual hospital stay after delivery?

Answer: Length of stay depends on the course of labor and the condition of the mother and baby; the doctor will specify the expected duration after delivery.

Question: What happens immediately after the baby is born?

Answer: Initial contact is arranged, the newborn is examined by a neonatologist, and both mother and baby are monitored (including CTG if necessary).

Question: Can I meet the doctor beforehand and discuss the plan?

Answer: Yes — you can schedule a consultation to discuss your preferences, options, and decision criteria.

Question: How do I know when it's time to go to the hospital if my condition changes?

Answer: Seek medical attention promptly for vaginal bleeding, rupture of membranes, regular contractions, decreased fetal movements, or any sudden change in how you feel.