Morken et al. have a number of comments regarding our paper.1 We are pleased that we are given the opportunity to clarify our findings and conclusions. Morken et al. claim that we ignore the possible confounding effect of preterm birth and plurality. In contrast, in Table I we present odds ratios (OR) adjusted for plurality, preterm birth, and gestational age, separately and combined with other known risk factors. These analyses suggested (as expected) confounding, and justified the stratified analyses. The stratified analyses are also presented in Table I, and indicated that breech presentation was a risk factor, independent of plurality and preterm birth. It is well known that the prevalence of cerebral palsy (CP) is higher among children born preterm than at term. However, the statement made by Morken et al. that preterm birth is the most important determinant of CP in breech deliveries is questionable. As discussed by us (and many others), association does not necessarily indicate causation. In our population preterm birth might have been the cause of CP in some of the breech births. However, one cannot rule out that brain injury can cause preterm birth or even more likely that CP and preterm birth share a common cause, a third factor. We considered this knowledge to be well established but we agree that we might have commented further on the findings in the group of children born preterm. Morken et al. claim that after having established breech as an independent risk factor for CP, ‘… it is misleading to compare infants born in breech presentation delivered vaginally with those born in vertex presentation’. This comparison is certainly not misleading but rather an attempt to assess whether mode of delivery may modify the effect of breech presentation, as was also done in the Swedish study.2 The results indicate that the risk of CP is not elevated in Caesarean section term breech delivery (OR 2.3, 95% confidence interval [CI] 0.8–6.2) as opposed to vaginal term breech delivery (OR 3.9, 95% CI 1.6–9.7). However, the CIs are overlapping and there is every reason to be cautious in the conclusion. In our paper we also emphasized that observational studies do not allow definite conclusions. Indeed, we did not conclude as Morken et al. assert that ‘… the risk of CP could have been reduced by Caesarean section in all cases of term breech presentation …’. Instead we concluded that significantly larger studies are needed to clarify this question. We would further underscore that our main conclusion is based upon the associations observed between breech presentation and CP, which was emphasized in the title, abstract, discussion, and in the main conclusion. Our paper is not an attack on current Norwegian clinical obstetric practice. We have confidence in Norwegian obstetricians and their practice. However, Norway is one of the few countries practicing term breech vaginal delivery. A scientific debate on the safety of this procedure should go on. Our results and others2 have raised questions which should be pursued in larger multicenter studies.