Date of Award

2023

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Elizabeth Gabzdyl

Readers

Rixa Freeze

Abstract

A fetus is considered breech when the presenting part is the buttocks, foot/feet, or hips. Annually, approximately 5% of all pregnancies in the United States (U.S.) are breech at term (Centers for Disease Control and Prevention, 2021). Vaginal delivery of a breech baby is increasingly rare in the U.S., as 95% of those presenting as breech at term are delivered via cesarean section (Centers for Disease Control and Prevention, 2021). While the number of vaginal breech deliveries has been trending downwards since the 1970s, the rate dropped precipitously in 2000 after the Term Breech Trial (ACOG, 2020; Freeze, 2019; Hunter, 2014). The Term Breech Trial (TBT) found that “Perinatal mortality, neonatal mortality, or serious neonatal morbidity was significantly lower for the planned caesarean section group than for the planned vaginal birth group” (Hannah et al., 2000). The most commonly cited concerns about vaginal breech delivery include risk of head entrapment, where the body emerges but the head (typically the widest part of the fetus) is stuck in the pelvis, and birth trauma/injury related to manipulation of the fetus during delivery (ACOG, 2020; Berhan & Haileamlak, 2016).

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