How should we deliver preterm breech babies?

The Term Breech Trial in 2000 changed the way we deliver babies. Ever since Dr. Hannah published that pivotal study, obstetricians have increasingly favored delivering breech (butt first) babies by c-section instead of vaginal delivery. By term, which is 37 weeks of pregnancy and later, only about 3 to 4% of infants are breech. However, earlier in pregnancy, many more infants haven’t had a chance to flip over to head first yet. At 26 weeks, a quarter of infants are breech, and at 32 weeks, 15% are still breech. What happens if a baby is born preterm? More of these infants are in the breech position, but we don’t have a pivotal randomized trial like the Term Breech Trial to guide us.