Treatment Overview. External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.

What is the meaning of ECV?

External cephalic version (ECV) is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first. It is a manual procedure that is recommended by national guidelines for breech presentation of a pregnancy with a single baby, in order to enable vaginal delivery.

What happens during an ECV?

During an external cephalic version, your doctor will place their hand on your belly to physically push the baby into the optimal position. The procedure usually takes around 5 minutes and your baby’s heart rate will be monitored before, during, and after the procedure.

What is ECV in pregnancy?

External cephalic version (ECV) is an attempt to turn the fetus so that he or she is head down. ECV can improve your chance of having a vaginal birth. If the fetus is breech and your pregnancy is greater than 36 weeks your health care professional may suggest ECV.

Is ECV safe for baby?

Is ECV safe for my baby and I? ECV is generally safe, however, like any medical procedure, rare complications can occur. A small number of women may experience bleeding behind the placenta and/or damage to the womb.

When is ECV offered?

ECV is usually performed after 36 or 37 weeks of pregnancy. However, it can be performed right up until the early stages of labour. You do not need to make any preparations for your ECV.

When is ECV?

ECV is usually offered when you are 36-37 weeks pregnant, as we estimate that most babies should have turned on their own by this stage and it would allow time for your baby’s head to engage, ready for birth.

Is breech birth more painful?

Giving birth to a breech baby vaginally is not usually any more painful than a head-down position, as you’ll have the same pain relief options available to you, although it does carry a higher risk of perinatal morbidity (2:1000 compared to 1:1000 with a cephalic baby).

How do you feel after ECV?

You may feel some pain or discomfort during the procedure. You may also have nausea, and you may vomit. This procedure may cause labor to start, or cause premature rupture of the membranes (PROM). PROM means fluid leaks from your amniotic sac before labor begins.

Are breech C sections more difficult?

Cesarean section in breech or transverse presentation involves more complicated procedures than cesarean section in cephalic presentation because the former requires additional manipulations for guiding the presenting part of the fetus, liberation of the arms, and the after-coming head delivery; therefore, those …

Article first time published on

Where do they cut for episiotomy?

An episiotomy is a cut (incision) through the area between your vaginal opening and your anus. This area is called the perineum. This procedure is done to make your vaginal opening larger for childbirth.

Do you need epidural for ECV?

Conclusion: The use of epidural anesthesia significantly increases the success rate for ECV for breech presentation.

What happens if you refuse a ECV?

If the baby does not turn or if you decline an ECV you may choose, after discussion with the consultant obstetrician, to: • Have an elective caesarean section. Continue the pregnancy with the baby in the breech position and have a vaginal breech delivery.

How painful is ECV?

An ECV can be physically uncomfortable for some as well as emotionally taxing. Being okay with the potential for discomfort and even pain (though many mamas do not report pain) is part of the decision making process. Some providers will administer an epidural for an ECV.

How can I get my baby to stay head down?

Long, brisk walks. Wearing a pregnancy belt. Doing Side-lying Releases on both sides daily (for a while), and then twice a week. Keep balancing (you’ve done good work, but keep going so tight muscles don’t return and create issues again)

Do breech babies have problems later in life?

Although most breech babies are born healthy, they do have a slightly higher risk for certain problems than babies in the normal position do. Most of these problems are detected by 20 week ultrasounds. So if nothing has been identified to this point then most likely the baby is normal.

Can baby turn back after an ECV?

The chance of your baby turning back to breech after a successful ECV is about 2-3% (very low).

What is the success rate of turning a breech baby?

The average success rate for turning a baby out of the breech position was 58%. The overall complication rate was 6%, and the rate of serious complications (placenta abruption or stillbirth) was 0.24%. There were 12 stillbirths out of the 12,955 cases, and two of these deaths were related to the ECV.

How often does ECV lead to C section?

Although complications from an ECV are rare, it is recommended that the procedure is done by an experienced health professional, in a hospital where there are facilities for emergency caesarean section. About 1 in 1,000 women go into labour after an ECV. About 1 in 200 women need an immediate caesarean section.

How long after ECV did you go into labor?

Out of the 67 cases of successful ECV, five (7.46%) fetuses reverted back to either breech presentation or transverse. All of them presented in labour, between 9 and 24 days after ECV, and had emergency caesarean delivery.

Can I drive after a ECV?

Please plan to be at the hospital for up to three hours. This allows plenty of time for assessment before and after the ECV as well as the procedure itself. We recommend that you have someone to drive you home afterwards.

Are breech babies smaller?

Breech babies were shown to have a smaller mean biparietal diameter (BPD) neonatally compared with that of a matched group of vertex babies. This was due to a mild skull deformation which occurred in at least one-third of 100 consecutive term breech babies examined.

How long does an ECV take?

ECV is done in the hospital and staff will let you know when and where it will be done. You need to make an appointment. The ECV only takes a few minutes, but the entire pre- and post-assessment procedure takes about 1-3 hours.

Is ECV safe?

ECVs are usually 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.

How long does a breech C-section take?

How long does the cesarean section procedure take? The typical C-section takes about 45 minutes. After the baby is delivered, your healthcare provider will stitch up the uterus and close the incision in your abdomen. There are different types of emergency situations that can arise during a delivery.

What should I do the night before my C-section?

The night or morning before you come in for your C-section, we might ask you to shower or bathe with special soap that we’ll give you ahead of time (or tell you how to obtain at a drug store). The goal is to kill bacteria on the skin and reduce the risk of infection following your C-section.

What Birth Defects Can a breech baby have?

A baby who is breech may be very small or may have birth defects. Because the head is delivered last, breech babies are also susceptible to umbilical cord compression and asphyxiation. When the umbilical cord becomes compressed, there is diminished oxygen flow to the baby.

How do you poop after an episiotomy?

Drink plenty of fluids (unless your doctor tells you not to). If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fibre, a stool softener, or a mild laxative.

Do episiotomies make you tighter?

Regardless of whether a tear happens on its own or as a result of an episiotomy, it’s not even possible to make a vagina tighter with stitching, according to OBGYN Jesanna Cooper, MD.

Is episiotomy better than C section?

In some emergency circumstances where a baby needs to be delivered quickly, Levy said an episiotomy can be a lifesaving procedure that is less risky than a Cesarean section delivery, which is a major surgery.

How do you know when the baby's head is down?

1. feel their head low down in your belly.
2. feel their bottom or legs above your belly button.
3. feel larger movements — bottom or legs — higher up toward your rib cage.
4. feel smaller movements — hands or elbows — low down in your pelvis.