And yet, that conclusion is flatly contradicted by an earlier study from the UK. In 1987, after reviewing 10 years of experience of both methods, doctors at the Leeds University Hospital concluded that CS is less hazardous: ". . . vaginal delivery may be the more dangerous maternal option," they reported (J Perinat Med, 1987; 15: 531-43).

Two very recent studies on the subject have only served to fuel the controversy. Last January, an Israeli expert published a stinging condemnation of the original Canadian review, complaining of "serious" flaws in its design and methods-and, not surprisingly, totally rubbishing its conclusions (Am J Obstet Gynecol, 2006; 194: 20-5). Three months later, a French report went further, questioning the whole rationale for opting for CS in breech births. In the right hands, it said, the records showed that natural breech births are just as safe as CS deliveries (Am J Obstet Gynecol, 2006; 194: 1002-11).

Tony Edwards