Breech birth: what is the recommended action?

• A. Rapid transport
• B. Attempt to deliver breech on scene
• C. Push head back in
• D. Crank leg removal

Answer: (A)

Breech births carry higher risk for both baby and mother, including head entrapment and umbilical cord problems. The safest EMS action is to get the mother to a hospital with obstetric and neonatal care as quickly as possible, while providing supportive care en route. This means prioritizing rapid transport over trying to complete the delivery on scene.

During transport, focus on keeping the mother comfortable and stable, ensuring airway and breathing, applying oxygen if needed, monitoring vital signs, and keeping the newborn warm. Do not attempt to pull on the baby, push the head back in, or perform any drastic maneuvers. These actions can worsen injury or impede the delivery of the head, which is a high-risk event in breech births. If the baby begins to deliver on scene and you are not trained for a controlled breech delivery, continue supportive care and expedite transport to the nearest obstetric-capable facility.