Ethical Considerations for Term Singleton Breech Cesarean Section

Shoko Kubota
Volume 5 Issue 1 Pages 1-13
First Published: July 19, 2022



In Japan, most of the modes of term singleton breech deliveries are planned cesarean sections. Obstetrical facilities often have a policy of planned cesarean sections for all breech pregnancies. The Guidelines for Obstetrical Practice in Japan state that vaginal delivery for breech presentation can be an option under certain conditions, and some facilities perform vaginal breech delivery. In this paper I organize the background issues behind the current situation that many of the obstetrical facilities have a policy of planned cesarean section for all breech pregnancies including not absolutely indicated. I also discuss how we should make informed consent for term breech cesarean delivery and how healthcare professionals should consider about women’s rights. There are two social background issues, one is that the professional skills of vaginal breech delivery are becoming no longer passed on, and the other is the problem of perinatal care system in Japan. I argue that even if vaginal breech delivery is not an option, healthcare professionals should provide the information for women include the social backgrounds and should consider the reason behind women’s preference.


Key words

breech delivery, cesarean section, natural birth, informed consent