The unexpected diagnosis of breech presentation upon admission in labour affects approximately 1:100 women and presents an ethical dilemma for health professionals involved, particularly when this occurs in the context of midwifery-led care. This article critically examines current guidelines recommending caesarean section on the basis of available evidence, outlines factors which must be considered in order to provide safe care, makes recommendations for women-centred counselling, and explores the role of the midwife in this situation
