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The Breech Clinic
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Siege [dot] Clini-obs [dot] erasme [at] hubruxelles [dot] be (Contact the Breech Clinic directly )
Is your baby in the breech position?
Let’s talk about your delivery options
The Erasmus Hospital Breech Clinic supports patients and couples whose baby is in the breech position after 36-37 weeks of pregnancy.
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In 2023, approximately 4% of pregnancies in Brussels and 5% in Wallonia were in the breech position at term. Up to 92% of Caesarean deliveries were carried out for this reason alone, not all of which were justified. Given the right conditions, there is no reason why a vaginal delivery cannot be considered as an option for these babies (Ref. : Van Leeuw V, Leroy Ch. Santé périnatale en Région bruxelloise – Année 2023. Centre d’Épidémiologie Périnatale, 2024).
In 2016 the Erasmus Hospital put into place a care pathway to accompany future mothers and parents in making their decisions, providing them with clear and detailed information on the available care options, including that of performing a version to turn the baby.
In 2016 the Erasmus Hospital put into place a care pathway to accompany future mothers and parents in making their decisions, providing them with clear and detailed information on the available care options.
The breech delivery options
- After 36 weeks of pregnancy, we have a meeting at which we discuss the possibility of carrying out an External Cephalic Version (ECV), This procedure involves an obstetrician, assisted by ultrasound parameters, applying manual external pressure that causes your baby to flip to a head-down position.
- If the ECV is unsuccessful or if you decide not try it, a pelvimetry (a scan to measure the size of your pelvis) is proposed to explore the possibilities of a vaginal delivery.
- We also discuss the various delivery options: vaginal, a possibility given the right conditions, or a Caesarean.
- Finally, if you opt for a vaginal delivery, specific preparations are proposed for a breech birth. We also propose appointments to look at the various delivery options for your breech baby.
- A physiological approach will be favoured for the delivery of your foetus in a breech position.
The gentle C-section at the H.U.B Erasmus Hospital
Dr. Sara Derisbourg
Gynaecologist obstetrician
Specialities: monitoring high risk pregnancies, prenatal monitoring (clear information, ECV, etc.) and delivery of breech foetuses, follow-up of breastfeeding complications (committee member of the Baby-Friendly Hospital Initiative, Erasmus Hospital).
Doctor Sara Derisbourg is working on a thesis on caring for breech babies at term. She was actively involved in opening the Breech Clinic, helping to develop the care pathway, brochures and other resources.
A specialised team dedicated to the well-being of you and your baby
Doctors
- Dr De Coninck
- Dr Derisbourg
- Dr Di Giovanni
- Dr Garofalo
- Dr Lamy
- Dr Mincke
- Dr Romnée
- Dr Valcarenghi
- Dr Vercoutere
- Dr Zaytouni
Midwives
- Pauline Eon, head midwife of the delivery room, Maternal Intensive Care (MIC) and the Cocon
- Martine Pierreux
- Marie Trullemans
- Delivery room midwifery team
The departments we work with
The departments we work with
Anaesthesiology
Paediatrics
An HSO certified clinic
The Breech Clinic holds the HSO (Health Standards Organization) label that attests to the quality of patient care.
Ressources
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1. Why is my baby in the breech position ?
In most cases, there is no identified cause for the baby being in the breech position.
However, it could be linked to:- Uterine malformations, the presence of fibromas.
- A reduction in amniotic liquid.
- The insertion of the placenta praevia or low placenta
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2. Is the external cephalic version (ECV) a painful procedure?
In most cases, the procedure is not painful. It is generally described as uncomfortable or unpleasant. About 5 to 7% of patients report pain following the procedure. However, during the procedure, we encourage you to communicate with the practitioner and report any pain you may experience. The procedure will be stopped if the pain becomes intolerable.
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3. Is the ECV painful for my baby?
We have no evidence to suggest that an external version would be painful for the baby. In general, pain in utero is indicated by an increase in heart rate. The fetal heart rate will be monitored before, during, and after the external version. If there are any concerns or doubts, the procedure will be stopped.
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4. Is a Caesarean always indicated for a baby in the breech position?
No. In fact, if the obstetric and medical conditions of both the patient and the baby are favorable, a vaginal delivery of a breech baby is entirely possible.
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5. Is a vaginal delivery more painful for a breech baby than for a baby in a head-down position?
There is no scientific evidence to suggest that giving birth to a baby in a breech position is more painful than giving birth to a baby in a head-first position. Childbirth without an epidural is painful in the vast majority of cases, whether the baby is in a breech position or head-first. The decision to have an epidural is entirely up to you.
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6. Is an ECV possible if the umbilical cord is wrapped around the neck?
First of all, it is not always easy to detect the umbilical cord around the neck. In any case, this is not a contraindication to considering an external version.
Conference on breech births in Belgium
The H.U.B. Breech Clinic invites you on the 25 and 26 September 2026 to a conference on breech births at term with a discussion of the latest recommendations and clinical practices plus simulations. This conference is accredited and will be held in French. It will be of interest to doctors, midwives and perinatal professionals.