pregnant mother

If your baby is in a breech position as you near your due date, your provider may give you the option of attempting an external cephalic version (ECV), a procedure used to turn your baby in the womb. Here are the benefits and risks of an ECV, and how it’s performed.

What Is an External Cephalic Version?

An ECV is typically done around 37 weeks of pregnancy to rotate a baby from a breech or transverse position into a head down position. The reason for doing this? A head-down, or cephalic presentation, is the ideal position to be able to give birth vaginally. While some women may want an ECV in order to fulfill their desire for a vaginal delivery, others may choose to have a C-section delivery instead. You and your provider can discuss the best delivery scenario for you, and help you create a birth plan.

How Is an ECV Done?

An external cephalic version is done completely on the outside of your body. Your provider—and sometimes another member of the care team—will place their hands on your belly, and apply very firm pressure to help your little one roll into a head-down position. In order to ensure baby is turning the correct way, ultrasound may be used to guide the procedure. In some cases your provider may give you medication to help you relax and relieve any discomfort during the process.

Your baby’s heart will be monitored throughout the ECV. If your provider notices any problems with you or your baby’s vital signs, the procedure will be stopped right away. Most times an ECV is done near an operating room so that a C-section can be performed quickly in the event of any complications.

What Are the Risks of an ECV?

Even though an ECV isn’t an invasive procedure, there are still risks involved. Complications to an ECV can include:

  • Premature rupture of membranes (your water breaks)
  • Changes in your baby’s heart rate
  • Placental abruption
  • Preterm labor

If you are not a candidate for an ECV, your provider will discuss scheduling a C-section instead for the safety of you and your little one. Reasons that an ECV may not be possible include:

  • Pregnancy with multiples
  • Any concerns about your baby’s health
  • Abnormalities of the reproductive system
  • Irregular placenta placement or other placental complications
  • High blood pressure, diabetes, or another preexisting condition

Another thing to note? An external cephalic version simply might not be successful. While more than 50 percent of ECV attempts succeed, some babies move back into the breech position where they started. An ECV may be attempted again. However it’s important to remember that it becomes harder to turn your baby as you approach your due date and baby grows larger.

We know it can feel frustrating if your little one is breech or transverse and you hope to give birth vaginally. Take time to weigh the benefits and risks of trying to flip your baby, and do your best to feel open to the chances of a C-section delivery. No matter how you give birth, you’re a warrior, mama—and your little one will be in the world soon.

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