External Cephalic Version

January 2, 2019

What is it?

An external cephalic version (ECV) is a procedure to turn your baby from a breech position into a head down (cephalic) position.

The procedure is completed after 37 weeks of pregnancy if your baby has not turned itself.

During pregnancy your baby will move around, changing positions. It might seem like they are dancing around inside – having a little party in there. By 36 weeks most babies should have settled into a head down position.

Sometimes this is not the case with approximately 3 in 100 babies still being in a breech position at 36 weeks.


How is it done?

The ECV is completed by an obstetrician by manipulation through the mother’s abdomen.

Firstly, we will monitor both you and your baby for approximately 30 minutes before the procedure. The CTG is an electronic monitor that is attached to your abdomen with a stretchy belt. It monitors the baby’s heartbeat through the electronic belt.

An ultrasound may also be required to confirm the baby’s exact position.

If required, medication can be given via a small needle into your hand to relax your uterus.

To turn the baby I will place my hands on your abdomen to try to turn your baby into a head-down position. Using gentle pressure I will help your baby somersault in your uterus so it is then laying head down.

It is not a painful procedure, some mothers tell me it is a little uncomfortable. An ECV is safe when performed by a qualified obstetrician and does not cause labour to begin.

Once the ECV is complete we will monitor your baby’s heart rate via the CTV.


What is breech?

Breech presentation is when your baby is lying either feet or bottom first in the womb. In early pregnancy, a breech position is very common as the baby moves around a lot.

There are many things that cause your baby to be in a breech position including the amount of amniotic fluid around the baby, a low lying placenta, fibroids as well as uterus muscles being lax – which is usually caused by having a number of babies.


What if it doesn’t work?

ECV improves your chances of having a vaginal birth and is successful 50% of the time.

If it is not successful, we can try the ECV again on another day.

Following an unsuccessful second attempt, we will discuss birth choices including a breech vaginal birth and a planned caesarean section.

You can read more about birth options here

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