What Is External Cephalic Version?

When you're pregnant, long before you feel that first fluttery kick, your baby has been moving and grooving all over your womb. That usually keeps up until the 36-week mark, when most babies strike their final pose. They get into a headfirst -- or cephalic -- position toward the opening of your birth canal.

But some babies have other plans. About 4% are breech, which means they're set up to come out bottom or feet first. That makes a vaginal birth more difficult. Your doctor may suggest turning your baby into the headfirst position with a procedure called an external cephalic version (ECV).

How It Works

Your baby's heartbeat will be monitored with a cardiotocograph (CTG) for about a half-hour before the ECV. In some cases, you may get medicine through an IV to relax your uterus. This won't affect your baby.

Then, by pressing her hands on the outside of your belly, your doctor will try to turn your baby. The goal is to get your baby to do a little flip in your womb and finish up head-down.

Your doctor may use an ultrasound to check your baby's position and guide the process.

Does It Hurt?

To turn your baby, your doctor will use a fair amount of firm pressure. Everyone reacts differently, so you might feel discomfort or pain.

Are There Reasons to Avoid an ECV?

An ECV isn't right for you if you're expecting more than one baby at a time or you need a C-section for other health reasons.

It also works best on women with a pear-shaped womb and not those with a heart-shaped womb, called a bicornuate uterus.

Other reasons your doctor might tell you not to get an ECV are:

Are There Any Risks?

ECVs are generally safe, but there are some risks. In rare cases, it can cause changes in your baby's heart rate, tearing of the placenta, and preterm labor.

The procedure is usually done near a delivery room in case you need an emergency C-section.


What if It Doesn't Work?

ECVs are a success about half the time. If your doctor can't get your baby to flip after the first attempt, she may try again after a week or so.

After an ECV, sometimes babies flip to the headfirst position, then flip back to breech. And sometimes breech babies flip on their own before birth, though the bigger they get, the less room there is to move.

Doctors deliver most breech babies by C-section. A vaginal birth may still be possible, depending on your health, your baby's health, and his position. Ask your doctor about your options.

Are There Possible Complications From an ECV?

After a successful ECV, most women go on to have normal vaginal births. But call your doctor right away if you have contractions, bleeding, or you don't feel your baby moving the way you did before the procedure.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on May 28, 2020



Pregnancy Birth & Baby: "External cephalic version (ECV)."

Mayo Clinic: "Fetal presentation before birth."

The American College of Obstetricians and Gynecologists: "If Your Baby Is Breech."

Royal College of Obstetricians and Gynaecologists: "Turning a breech baby in the womb (external cephalic version)."

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