[2] Doctors and midwives in the developing world often lack many of the skills required to safely assist women giving birth to a breech baby vaginally.

[2] Also, delivering all breech babies by caesarean section in developing countries is difficult to implement as there are not always resources available to provide this service.

If this occurs, the Løvset manoeuvre may be employed, or the arm may be manually brought to a position in front of the chest.

In order to present the smallest diameter (9.5 cm) to the pelvis, the baby's head must be flexed (chin to chest).

If oxygen deprivation is prolonged, it may cause permanent neurological damage (for instance, cerebral palsy) or death.

[26] Injury to the brain and skull may occur due to the rapid passage of the baby's head through the mother's pelvis.

In contrast, a baby going through labor in the head-down position usually experiences gradual molding (temporary reshaping of the skull) over the course of a few hours.

The fetal head may be controlled by a special two-handed grip called the Mauriceau–Smellie–Veit maneuver or the elective application of forceps.

Related to potential head trauma, researchers have identified a relationship between breech birth and autism.

Positioning the baby incorrectly while using forceps to deliver the after coming head can damage the spine or spinal cord.

As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually the cervix begins to thin and open.

[31] In the more common breech presentations, the baby's bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.

In order to begin the birth, a descent of the podalic pole along with compaction and internal rotation needs to occur.

This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other.

The combination of maternal muscle tone and uterine contractions causes the baby's head to flex, chin to chest.

Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen.

Due to this and other risks, babies in breech position are often born by a planned caesarean section in developed countries.

The breech extraction is the procedure that involves the obstetrician grabbing the second twin's feet and pulling him/her into the birth canal.

[3] ECV does not always work, but it does improve the mother's chances of giving birth to her baby vaginally and avoiding a cesarean section.

Drugs called beta-stimulant tocolytics help the woman's muscles to relax so that the pressure during the ECV does not have to be so great.

Giving the woman these drugs before the ECV improves the chances of her having a vaginal delivery because the baby is more likely to turn and stay head down.

[34] In a breech delivery, the process involves a sequential progression of movements for the buttocks, shoulders, and head to facilitate the baby's passage through the birth canal.