When buttocks present and delivery is imminent, which step is recommended?

• A. Position the woman with buttocks at edge of bed or stretcher, legs flexed
• B. Allow newborn's buttocks and trunk to deliver spontaneously
• C. Lower the newborn slightly
• D. Do not attempt delivery until head crowns

Answer: (C)

In a breech delivery where the buttocks are presenting, the priority is to deliver the breech part first in a controlled way. When delivery is imminent, gently lower the newborn toward the perineum so the buttocks and then the trunk can deliver before the head. This slow, deliberate descent helps prevent head entrapment and reduces the risk of umbilical cord problems that can occur if the birth proceeds too rapidly. Waiting for the head to crown or trying to deliver the rest spontaneously without this control increases the chance of complications, since the head is more difficult to deliver after the body has already delivered in a breech presentation. Emphasize a calm, gentle descent of the breech and seek additional help as needed.