Counseling practices, opinions and personal preferences regarding mode of delivery for term breech presentation: A survey of healthcare professionals

Objective To assess healthcare professionals' opinions, counseling practices, and personal preferences regarding mode of delivery for term breech presentation, and to explore variations according to gender, professional status, experience, and institutional policy. Methods We conducted a multicenter cross-sectional survey in six tertiary maternity units in the Paris area between September 2025 and January 2026. Obstetrics residents, senior obstetricians, and midwives were invited to complete an anonymous electronic questionnaire exploring counseling practices, reported neutrality of information, and personal preferences regarding mode of delivery. Comparisons were performed according to gender, professional status, experience, and institutional policy. Results A total of 242 healthcare professionals responded (response rate, 46.1%). Overall, 81.4% reported a personal preference for planned vaginal breech delivery. Most respondents considered that, in cases of breech presentation, the final decision regarding mode of delivery should belong to the patient (88.8% vs 57.9% for cephalic presentation; p < 0.01). Only 54.1% reported providing neutral counseling. Male professionals were more likely than female professionals to support planned vaginal delivery in nulliparous women (90.9% vs 72.2%; p = 0.01) and in women with a previous uterine scar (69.7% vs 50.2%; p = 0.04). Support for planned vaginal breech delivery differed according to professional status ( p = 0.04), with lower rates among midwives with more than 5 years of experience (69.1%). Institutional policy had a major influence: professionals working in centers favoring planned vaginal breech delivery were more likely to support this option than those working in centers with elective cesarean policies (84.9% vs 61.1%; p < 0.01), and counseling was more often oriented toward cesarean delivery in the latter group (47.2% vs 2.4%; p < 0.01). Conclusions This study showed that reported counseling practices for term breech presentation are frequently non-neutral and that healthcare professionals' opinions and reported counseling practices vary according to professional characteristics and institutional setting. These findings highlight the heterogeneity of counseling practices and emphasize the importance of promoting balanced information and shared decision-making to support women's informed choice regarding mode of delivery.