Using national guidelines and recent publications vaginal breech birth covers the risk factors, maneouvres and multi-professional considerations for a vaginal breech birth. The algorithm covers how to expedite birth, if there is delay or concerns about fetal wellbeing. Key learning points: Women with antenatal breech presentation should be provided with information regarding the risks and benefits associated with both vaginal birth and caesarean birth. An unplanned vaginal breech labour and birth is associated with increased risks, particularly to the fetus. Recommend continuous electronic fetal monitoring (CEFM) intrapartum (continue monitoring up until birth, even after a decision for emergency caesarean birth). Practitioners providing care at vaginal breech birth should be trained and skilled. Ensure a ‘hands poised’ approach, with appropriate intervention, where there is delay in progress and/or evidence of poor fetal condition. Maternal position at vaginal breech birth should depend on maternal choice and the experience of the practitioner. Choice of manoeuvres/techniques required at birth should depend on the experience and/or choice of the attending practitioner in relation to maternal positioning.