Breech presentation

Essential equipment


  1. As the fetus begins to emerge, the hips will deliver

  2. Avoid aggressive traction, which increases the risk for head entrapment or nuchal arm entrapment (allow mother to push as far as possible)

  3. Once the infant is delivered to the level of the sacrum, rotate the sacrum to an anterior-posterior orientation, then sweep anterior leg over the body to deliver leg

  4. Then rotate sacrum 180 degrees, and repeat leg delivery of opposite leg

  5. Wrap a towel around legs and torso for greater traction

  6. Allow mother to push until delivered to the level of the scapulae

  7. When the scapulae appear under the symphysis, sweep the anterior shoulder to unlock it from the pubic bone, Deliver the anterior arm

  8. Rotate the shoulder girdle 180 degrees. Deliver opposite shoulder as above

  9. Rest the fetal body on your dominant palm and forearm

  10. Place your dominant-hand index and middle fingers over the infant’s maxilla to maintain head flexion (chin to chest). The infant's face should be facing the floor

  11. Place your non-dominant hand between the scapulae

  12. Apply downward traction on the shoulders with non-dominant hand, then elevate the body of the fetus to deliver the head