Breech baby at the end of Pregnancy and ECV

If your baby is breech (lying bottom-first or feet-first in the womb (uterus) instead of the usual head-first position), your obstetrician may offer you a technique known as External Cephalic Version (ECV). This is when gentle pressure is put on your abdomen to help your baby turn a somersault in the womb until he or she is facing head-first.

It is recommended that External Cephalic Version (ECV) is offered after 37 weeks of pregnancy to women with breech presentation. If an ECV is successful this will increase the likelihood of a normal vaginal birth. For more information please read the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines on Breech baby at the end of pregnancy

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. About one in 200 babies need to be delivered by emergency caesarean section immediately after an ECV as a result of these complications. ECV does not usually cause labour to begin.

Therefore, we ask you to have nothing to eat or drink from 6am on the day of your ECV.

Does an ECV Work?

ECV is successful in turning babies to a head down position in four out of ten women in their first pregnancies and in six out of ten women who have previously had a baby. The chance of your baby returning back to the breech position is less than one in 20.

How is an ECV carried out?

The procedure is carried out on the Central Delivery Suite at Southmead Hospital. You will be on the unit for about three hours. Prior to doing the ECV an ultrasound scan is done to confirm that your baby is still breech, and a fetal heart rate trace is performed to check that all is well with your baby.

An injection will be given prior to the procedure to help to relax your womb while your baby is being turned, and the head of the bed may be tipped down to help the baby’s bottom come out of your pelvis.

The Doctor will place their hands on your tummy and encourage the baby to turn in a forward or backward roll, with the aim of finishing in a head down position.
This procedure can be uncomfortable and a few women, one in 20, will experience some pain.

If you find it too uncomfortable, tell the doctor and the procedure can be stopped if you wish.

An Ultrasound scan is repeated again after the procedure, and a further recording of the baby’s heart rate for a minimum of 45 minutes. After this, if all is well you can go home.

If you have a Rhesus negative blood group you may already have had an injection of Anti D during your pregnancy and be aware of why it is needed. However, during the ECV (whether it is successful or not) it is possible for your baby’s blood cells to mix with yours and therefore, before you can go home, you need to have a blood test (known as a Kleihauer) to see if this has occurred. You will then also be given another Anti D injection (before going home) and may need more Anti D within the next three days if the Kleihauer blood test indicates this is necessary.

On returning home

You should have no problems on returning home, however, it is wise to note any problems such as bleeding, unusual pain or reduced movements from the baby.

If you notice any of these you should contact the Central Delivery Suite immediately.