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26th Dec 2022

Breech babies: What is an ECV? And how and when is it performed?

When your little one just won't flip around.


It’s typically performed around 37 weeks.

I’ve always thought ECV to be a particularly torturous procedure to endure as an expectant mama.

External cephalic version: where a medical professional gets seriously handsie with your bump in an attempt to flip a breech baby around.

In a nutshell, breech means that your little one is lying bum or feet first in the womb. It’s pretty common in the first and second trimesters. And as your pregnancy progresses, a baby usually turns by itself… but not always. And that’s when an ECV might come into play.

Typically performed around the 37-week mark, here’s what to expect:

1) It will be performed in hospital. An ECV isn’t a risky procedure per say, but it can – very rarely – kick-off labour, which is why it wouldn’t be carried out in, say, a GP’s surgery.

2) A detailed fetal ultrasound will first confirm the baby’s position and weight, as well as where the placenta is, and amniotic fluid levels.

3) If it’s confirmed that your baby is breech, your doctor should discuss your options with you – including having a c-section – before proceeding with an ECV. It is also possible to give birth naturally when your baby is breech, but you’s need to have an experienced obstetrician present in the labour ward.

4) You may be given a tocolytic injection to relax the uterus and prevent you going into labour contractions.

5) The baby’s heart-rate will be monitored before, possibly during, and after the ECV to make sure it isn’t distressed.

6) Your doctor will use both hands and will first feel around for the baby’s head and bum. They will then try and push and rolls the fetus into position.

7) Different women report different levels of discomfort and pain – some say it’s merely unpleasant or a bit weird, others say it’s agony – albeit one that doesn’t last for too long.

8) Remember it’s possible that the baby – once turned successfully – will return to a breech position.

9) The Royal College Of Obstetricians And Gynaecologists in London says that around half of ECV procedures successfully remedy a breach baby.

Finally, an ECV won’t be carried out if:

  • Your waters have broken
  • The baby has  ‘dropped’ into your pelvis
  • You’re pregnant with multiples
  • Your preference is to have a caesarian