If Your Baby Is Breech: External Cephalic Version
Near the end of pregnancy, most babies
move into a head-down position for birth. But in some cases, a baby is in a breech
position. This means the baby is upright. Their buttocks or feet are in place to come
first. A breech position makes it hard to have a vaginal birth.
If your baby is breech, your
healthcare provider may press on your belly to try to turn the baby. The goal is to
position your baby head-down. This procedure is called an external cephalic version (ECV).
An ECV may be done if you are between 36 to 38 weeks (near term) in your pregnancy,
there are reasons not to do it. If the ECV works well, a vaginal birth is more likely.
Before the procedure
This procedure is usually done in a
hospital. Don’t eat or drink before the procedure. Follow all other directions you’re
given for getting ready.
Before the ECV, the medical team
will connect you to a fetal monitor. This is done to check your baby’s well-being
and after the procedure. You may also need these tests:
This may be done to:
Confirm that the baby is
in a breech position
Find out how much amniotic
fluid is in the uterus
Confirm where the placenta
Find or rule out any birth
defects (congenital problems)
Nonstress test and biophysical
These tests check your baby's
heart, well-being, and contraction pattern. One or both of these tests may be done
before and after the ECV.
Medical staff will take a small
sample of your blood to test. This is done to find out your blood type, screen for
problems, and do a complete blood count in case of an emergency.
During the procedure
Your healthcare provider may
use ultrasound during the procedure.
An IV (intravenous) line may
be put in your arm. This is to give fluids or medicines if needed.
The team may give you
medicine to relax your uterus. This can make it easier for the healthcare provider
to rotate your baby.
You will be placed in
position on the hospital bed.
The healthcare provider will
put their hands at certain points on your lower belly over your uterus. They will
press down on your belly and find your baby’s head and bottom.
They will try to push the
baby into a head-down position. This is done by trying to make the baby do a
slow-motion forward roll or back flip. You will feel pressure during this part of
Once the procedure is done,
the medical team will raise the head of your bed. This will help keep the baby in
the head-down position.
After the procedure
You will stay connected
to the fetal monitor. This is done to check your baby’s well-being. It also checks
for contractions. These can happen after an ECV. You will be kept track of up to 2
hours after the ECV, or as noted by your provider.
If you are Rh-negative, you
may have an Rh immunoglobulin injection. This is done to prevent an immune system
response called Rh sensitization. Rh sensitization can cause problems in a future
pregnancy if the baby's blood goes into your bloodstream.
Follow all discharge
directions from your healthcare provider.
You may need to have appointments
more often to check your baby’s position.
When to call your healthcare
Call your healthcare provider if
any of the following occur:
You have more
Fluid or blood is leaking
from your vagina
Your baby is moving less
You have other signs or
symptoms as directed by your healthcare provider
You have a lot of vaginal
Delivering your baby after ECV
Even if your baby’s position can’t
be changed, you may be able to have a vaginal birth. The type of birth you have should
depend on your healthcare provider’s experience. Most providers prefer to do a cesarean
section (C-section) for a breech baby. This is a birth done with surgery. For a
C-section, you will have medicine to block pain (anesthesia). But you are usually