Potential delivery pathways for the base case patient with breech presenting fetus. The patient with breech presenting fetus can go directly to cesarean delivery, or undergo ECV, either with (Pathway B) or without (Pathway C) spinal anesthesia. ECV success rates with and without spinal anesthesia were taken from our previous publications [19, 20]. Pathway A (no ECV) shows 100% CD rate, despite the possibility of vaginal breech delivery or spontaneous conversion to cephalic presentation. For pathways B2/B3 and C2/C3, following successful ECV, a cesarean delivery rate of 16% is used, based upon calculated data from Table 3. Costs associated with each pathway are presented in Table 3. VD = vaginal delivery, CD = cesarean delivery.