Scroll down (Read More) to see reference articles and the list of  books contributing to the Spinning Babies view on breech position and breech birth. 

There are a variety of snippets and links on this article.




Books on Breech. 


Breech Birth, Woman Wise. Maggie Banks, 1998 Birth Spirit Books, 15 Te Awa Rd., RD 3, Hamilton, New Zealand.   Order the book at

Commentary on The Hannah Breech Trial by Maggie Banks on  Radical Midwives.

Active Breech Birth: the point of least resistance by Maggie Banks. In March 2006, [Maggie Banks] attended the 1st International Breech Birth Conference in Vancouver, Canada with midwives, medical practitioners and researchers discussing research, safety and techniques used during vaginal breech birth ... (full article in PDF format) fromBirthSpirit.



CLick to go to Capers bookstore and
order Jane Evan's Breech Birth; What are my options? book

Breech Birth: What are my options by Jane Evans
Evans J., 2005 Breech Birth - What are my options? Association for Improvements in the Maternity Services, Manor Barn, Thurloxton, Taunton, Somerset, TA2 8RH

Buy at CAPERS bookstore.

From the Independent Midwives Association in the United Kingdom:

"Jane qualified as a midwife in 1976 and worked in the NHS for 20 years. She was instrumental in raising homebirth rates, introducing waterbirth and in developing a domino scheme in her local area of Hertfordshire. Jane has become renowned for her experience in breech birth, twin birth and VBAC. She has been a member of IMA since 1991."



Click to buy at another siteBreech Birth.  Benna Waites, 2003  Free Association Books, 57 Warren Street, London. W1T 5NR

Buy at Amazon






 Anne Frye's Holistic Midwifery, Volume 2 has reliable information on breech birth. Watch for Jane Evans  for whatever you can find on the cardinal movements of the birthing breech baby and compare. Use Anne Frye as the foundation for your birth studies, overall. 


Medical Research

Many of the academic articles published on breech birth in the last decade have centered around the controversary following the Term Breech Trial, also known as the Hannah Trial.


Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group.Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Lancet. 2000 Oct 21;356(9239):1375-83.


Then two years later, the Hannah group came out with a reassuring finding:


Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson S, Amankwah K, Cheng M, Gafni A, Guselle P, Helewa M, Hodnett ED, Hutton E, Kung R, McKay D, Ross S, Willan A; Term Breech Trial Collaborative Group. Am J Obstet Gynecol. 2004 Sep;191(3):864-71. Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.  Comment in:


An excellent explanation of the weakness of the Term Breech Trial came in 2004 from physician Andrew Kotaska:


Inappropriate use of randomised trials to evaluate complex phenomena: case study of vaginal breech delivery.  Andrew Kotaska, senior registrar1 BMJ  2004;329:1039-1042 (30 October), doi:10.1136/bmj.329.7473.1039   Department of Obstetrics and Gynaecology, University of British Columbia, BC Women's Hospital, Vancouver, BC, V6H 3V5 Canada


Another rebuttal came from Dr. Marek Glezerman calling to withdraw the Hannah recommendations for universal cesarean for breech position:

Five years to the term breech trial: the rise and fall of a randomized controlled trial. Am J Obstet Gynecol. 2006 Jan;194(1):20-5. Glezerman M. Department of Obstetrics and Gynecology, Wolfson Medical Center, The Helen Schneider Hospital for Women, Holon, Israel.

Comment in:



There are more great research articles, be sure to note if the articles and information you find on the web are research-based. Then read the research. Some research doesn't support the conclusions that the researchers make at the end of their published articles. Politics are in the birthing room. I'm not exempt, either. I have my opinion, too. Then, we have to separate the outcomes claimed for breech births where mother's are on their backs, and the midwife or physician extracts the baby compared to women on hands and knees  with a "hands-off-the-breech" approach. I was up putting this list on Spinning Babies as I waited for a midwife to call after her first breech catch. She and I had recently spent a day going over the Breech Update information I brought back to Minnesota after attending the Ottawa Breech conference last year. She had wanted to help the baby bend his knees, release his feet, etc. and every time she remembered me telling her, "hands off the breech, hands off the breech."   Mom and baby were tucked in, nursing, while she told me the story on her drive home. Now, I've got to go to bed, too.


  Breech Guidelines  

Vaginal or caesarean delivery? How research has turned breech birth around  Royal College of Midwives-Evidence-Based Midwifery, Sept, 2008 by Mary Steen,Carol Kingdon

I like this article because it sites Mary Cronk's breech protocols at the end. Very nice. Please take Mary Cronk's life-saving instruction to heart and hand:

"Independent midwife Mary Cronk has suggested that if the labour progresses spontaneously, (that is, the contractions come often, last longer, get stronger, the cervix effaces and dilates, and the breech descends through the pelvis), the baby will be born. If this does not happen there is no place for augmentation, that is, trying to push the baby through the pelvis with contractions driven by oxytocic drugs. Nor is there any place for trying to pull breeches through the pelvis with managed breech extractions. Labours that do not progress are telling us that the baby should be born by CS (Cronk, 1998). The RCOG has recommended that a CS should be considered if there is a delay in the descent of the breech at any stage in the second stage of labour (RCOG, 2006)."

Here are the Canadian Guidelines for Breech Birth. These are from the SOGC, and may differ from the guidelines of an experienced homebirth midwife who has done many breeches. See the quote above.

Vaginal Breech Delivery Guideline; The time has come. By Andre' B. Lalonde, Executive Vice-President of the Society of Obstetrics and Gynaecololgists of Canada.



Breech Birth stories on the web (please submit your own!)

While these are lovely stories, Spinning Babies does not link to them as examples of how to catch a breech. I'm hoping for photos of a mother in a knee-elbow (hands and knees) position with no one touching the baby. If you have the right to share such photos, I'd love to link to your site/blog. If you'd give me permission to use them in a Breech Update class for midwives, I'd love that, too, but I won't expect that from you, I'll just let it be an extra blessing if it comes my way. 

Later: Well, well, a little breechling blessed me. Her Mama, too! Here is the footage of a hands-off breech birth on the Spinning Babies blogspot.

Another hands-off footling breech birth this time with Lisa Barrett Australian Midwife. Give it time to load and suddenly you will see the little video screen on Lisa's blog.

Stories at the Coalition for Breech Birth website. Footling Breech story with photos.

Sebastian's Breech Birth. His mother said no to a version and no to a cesarean and went home to have her baby. Her skilled midwife did a hands-on breech delivery reflecting the influence of medical practice on home birth midwifery rather than the hands-and-knees, hands-off approach promoted here at Spinning Babies. Still, this a sweet birth story.

More breech births on Birth Love

A footling breech before the midwives could arrive, the lovely story of Bruno's birth.

A happy hospital birth story of a frank breech baby in the UK. James' Breech birth.

A happy hospital birth story of a frank breech baby in the US (Denver) with mom in the OR and forceps used (perhaps as a routine gesture?). Natalie's breech birthAm J Obstet Gynecol. 2004 Sep;191(3):864-71.



Review article

with pictures of Vaginal Assisted Breech Delivery. Extraction

Breech Presentation

Author: Richard Fischer, MD, Division Head, Maternal-Fetal Medicine, Professor, Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Cooper University Hospital, updated on their website on Jul 7, 2009.


Remember, an assisted breech delivery is a breech extraction. Compare these photos to the spontaneous movements of a breech birth in which the baby does her own cardinal movements - without "assistance."

See the preferred technique of a physician or midwife in this photo. See how he sits patiently, and not even in the same room as the laboring woman. Later, he will calmly hold his hands together while the baby emerges on her own.


Bibliography for Breech 2013


1.      2006 ACOG Guidelines on breech birth, American College of Obstetrics and Gynecology, US

2.      2009SOGC Guidelines on breech birth, Society Obstetrics Gyneocology, Canada

3.      J Alcantara, S Martingano, V Keeler, L Schuster, J Ohm Resolution of Breech Presentations Following Adjustment of Subluxations Utilizing the Webster Technique: A Case SeriesJ Pediatr Matern & Family 2011

4.      Banack, Connie Turning a Breech Baby! CLD CPD CCCE, Mother Care, 2003. Birth Can Be Safe, But Is it Worth the Effort? Andrew Kotaska, MD, FRCSC  J Obstet Gynaecol ;31(6):553–554  Canada 2009

5.      Banks, Maggie “Breech, Posterior and a Deflexed Head! An active birth solution?  Midwifery Today pp 22-24, Autumn 2009

6.      Banks,  Maggie Breech Wise. Birthspirit Books, 1998

7.      Calais-Germain, B. The Female Pelvis. Eastland Press 2003

8.      Cha LYS, et al. Levels of cord blood thyroid stimulating hormone after external cephalic version.BJOG.2001 Oct;108(10):1076-80. Even after successful ECV these babies show a difference in stress levels during birth.

9.      Coyle MESmith CAPeat B version by moxibustion for breech presentation. Cochrane Database Syst Rev. 2012 May 16;5:CD003928.

10.   Daviss, Betty-Anne; Johnson, Ken et al. CPM2000British Medical Journal 2005

11.   Daviss, B-A, et al. Evolving Evidence Since the Term Breech Trial:  Canadian Response, European Dissent, and Potential Solutions. March J Obstet Gynaecol Can 2010;32(3);217-224

12.   Evans, J. Joined-up Knowing. “The final piece of the breech birth jigsaw?” Essentially MIDIRS March 2012 Volume 3 Number 3, pp 46-49. 

13.   Evans, J. Understanding Physiological  Breech Birth. Essentially MIDIRS Feb 2012 Volume 3 Number 2, pp 17-21.

14.   Evans, J. Breech Birth;  What are my options?  Jane Evans for AIMS UK 2005

15.   Fox, A. E.; and R. W. Paton, Relationship between mode of delivery and developmental dysplasia of the hip in breech infants Journal of Bone and Joint Surgery - British Volume, Vol 92-B, Issue 12, 1695-1699. 
doi: 10.1302/0301-620X.92B12.24960 


16.   Frye, A. Holistic Midwifery, Volume 2, 2007

17.   Givens, Melissa L., Robert WestermyerTerm incomplete breech delivery in an ambulance: A case report The Journal of EmergencyMedicine, Volume 28, Issue 3, April 2005, Pages 301-303

18.   Glasø AH, et al.Breechdelivery--what influences on the mother's choice?Acta Obstet Gynecol Scand. 2013 Sep;92(9):1057-62. doi: 10.1111/aogs.12183. Epub 2013 Jun 27.

19.   Glezerman, Marek , MD “Five years to the term breech trial: The rise and fall of a randomized controlled trial” Glezerman concludes that the “original term breech trial recommendations should be withdrawn.” American Journal of Obstetrics and Gynecology 194, 20–5 (2006)

20.   Goffinet F, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, Breart G; PREMODA Study Group “Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium.” . Am J Obstet Gynecol. 194(4):1002-11. Apr 2006

21.   Guittier MJ, et al. Breech presentation and choice of mode of childbirth: a qualitative study of women's experiences. Midwifery.2011 Dec;27(6):e208-13. doi: 10.1016/j.midw.2010.08.008. Epub 2010 Nov 3.

22.   Hannah, Mary et al, for the Term Breech Trial Collaborative Group. “Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multicentre trial.” The Lancet Vol. 356 October 21, 2000

23.   Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD000083. DOI: 10.1002/14651858.CD000083.pub2 - See more at:

24.   Hofmeyr GJ, Kulier R. Cephalic version by postural management for breech presentation. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD000051. DOI: 10.1002/14651858.CD000051.pub2 - See more at:

25.   Iams, J. The Breech Term Trial, AJOG Volume 191, Issue 3, Pages 872-873 September 2004

26.   Jenis, Andrew D.; “Pregnancy, Breech Delivery” , Medscape Updated: Oct 26, 2009 Cites a 7% breech rate at 37-40 wks link:

27.   Kotaska, A.,  “Inappropriate use of randomised trials to evaluate complex phenomena: case study of vaginal breech delivery” BMJ (2004)

28.   Kotaska A, et al.  Vaginal delivery of breech presentation. J Obstet Gynaecol Can.2009 Jun;31(6):557-66, 567-78.

29.   Kuppens SM et alMaternal thyroid function during gestation is related to breech presentation at term. . Clin Endocrinology (Oxf) Volume 72, Issue 6, June, 2010, pp 820-824

30.   Lau TK, et al. Pregnancy outcome after successful external cephalic version for breech presentation at term. Am J Obstet Gynecol.1997 Jan;176(1 Pt 1):218-23. Examines increase in complicated births after ECV.

31.   Manyande, A. Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment to external cephalic version Midwifery Volume 25, Issue 6 , Pages 774-780, December 2009

32.   Mehl LE. Hypnosis and conversion of the breech to the vertex presentation.Arch Fam Med. 1994 Oct;3(10):881-7. 81% vs 48%

33.   Molkenboer, J. F. M. et al. Mothers' views of their childbirth experience two years after term breech delivery Journal of Psychosomatic Obstetrics & Gynecology 2008, Vol. 29, No. 1: Pages 39-44

34.   Mostello D, et al. Breech presentation at delivery: a marker for congenital anomaly? J Perinatol.2013 Oct 24. doi: 10.1038/jp.2013.132. [Epub ahead of print]

35.   Moxibustion for Bringing Babies Around to the Head-First Position Vas J, Aranda JM, Nishishinya B, et al. Correction of nonvertex presentation with moxibustion: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology 2009;201(3), 241-59.

36.   Nkwabong E, et al. Outcome of breechdeliveries in cameroonian nulliparous women.J Obstet Gynaecol India. 2012 Oct;62(5):531-5. doi: 10.1007/s13224-012-0201-5. Epub 2012 Oct 9.

37.   O'Callaghan M, et al. Cesarean Delivery and Cerebral Palsy: A Systematic Review and Meta-analysis.  Obstet Gynecol.2013 Dec;122(6):1169-75. doi: 10.1097/AOG.0000000000000020. Cesarean did not modify cerebral palsy outcome for breech presenting babies.

38.   Schutte, Joke al. Maternal deaths after elective cesarean section for breech presentation in the Netherlands. Acta Obstetricia et Gynecologica Scandinavica  Vol. 86, No. 2, Pages 240-243 2007

39.   Su M, McLeod L, Ross S, Willan A, Hannah WJ, Hutton E, et alFactors associated with adverse perinatal outcome in the Term Breech Trial. . Am J Obstet Gynecol. 2003 Sep;189(3):740-5. PubMed PMID: 14526305. Epub 2003/10/04. eng.

40.   Tully, GN; Identifying and resolving obstructed breech birth: when to touch and when to be hands-free. Midwifery Today Issue Number 106 (Summer 2013) Breech Birth, pp. 21-23

41.    Vas J, et al. “Moxibustion for Bringing Babies Around to the Head-First Position Correction of nonvertex presentation with moxibustion: A systematic review and meta-analysis.” American Journal of Obstetrics and Gynecology 2009;201(3), 241-59.

42.   Waites, Benna, Breech Birth London: Free Association Books, $29.95, 224 pages 2003


References in bold are within 5 years of application.



1.     A Breech in the System DVD by Karin Ecker, 2009-2010
2.      Breech water birth, You Tube 2009
4.      The Farm Video, Assisting a Vaginal Breech Birth, The Farm Midwives
8.      WHO International, Breech Delivery Techniques video




Active Birth, Janet Balaskas, Harvard Common Press. 252 pp.1992                 

Breech Birth. Benna Waites Free Association Books, Great Britain, 224 pp. 2003

Breech Birth? What are my options? Jane Evans AIMS 2008

Breech Wise. Maggie Banks  Birthspirit Books, 1998

Fearless Pregnancy, Wisdom and Reassurance from a Doctor, a Midwife and a Mom. Stuart J Fischbein, OB Fairwinds Press 2004

The Female Pelvis, Blandine Calais-Germain. Eastland Press 2003

Holistic Midwifery, Vol. II. Anne Frye. Labrys Press, (503) 255-3378.  2004

Homeopathy for Midwives, Barbara Geraghty, Churchill Livingstone, 2002

Human Labor and Birth, 4th edition, Harry Oxorn, Appleton-Century-Croft 1980

Sit Up and Take Notice, Positioning yourself for a better birth. Pauline Scott. Great Scott Publications. 2003

Understanding and Teaching Optimal Fetal Positioning. Jean Sutton and Pauline Scott. 2000



Other articles


“Belly Mapping; Using Kicks and Wiggles to Predict Posterior Labor.” Gail Tully, International Doula Vol No 2004.

“Outcomes of planned home births with certified professional midwives: large prospective study in North America” Kenneth C Johnson Betty-Anne Daviss, BMJ 2005; 330 : 1416 doi: 10.1136/bmj.330.7505.1416 (Published 16 June 2005)

 “The Safety of Homebirth: The Farm Study” Mark Durand, American Journal of Public Health, Vol. 82, 450-452 March 1992


Internet    Betty-Anne Daviss and Ken Johnson  Lisa Barrett’s blog and blog

http://www.StandandDeliver    Rixa Freeze’s blog Mary Cronk’s “Hands Off” article at


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Hi Gail, 

I want to say thank you! A first time mother's posterior birth went well [with] a short labor. Membranes ruptured about 8am. Her labor started about 6pm: 3cm dilated; LOP station -1; cervix soft and effaced. 

We did rebozo sifting, sidelying release, abdominal lift and tuck, standing sacral release, Dip the hip, circling on the birth ball, lunge and she birthed at 9.58pm in sidelying position with hands around the husband's neck.

Baby's head showed more molding on the right side. What you taught in the workshop and website made a difference!

Chiew Gin, Doula, Singapore