External Repositioning of the Baby

What is external cephalic version?

External cephalic version is a procedure for changing a baby's position in the uterus. Usually it is done to turn a breech baby to a vertex (headfirst) position. A breech baby's bottom or feet are in a position to come out before the head during delivery through the birth canal. Such a delivery may be hazardous. In a breech delivery, the baby's head may become trapped in the mother's cervix. Moving the baby to a headfirst position may allow you to avoid having a vaginal breech delivery or cesarean section (C-section).

When is it used?

This procedure may be done when your baby is in the breech position near your due date. It is done after about 36 weeks of pregnancy. Your healthcare provider may diagnose a breech position by feeling your abdomen and locating the baby's head and bottom. You may also have an ultrasound to check the baby's position.

What happens during the procedure?

This procedure should be done only in a place that is set up and ready for an emergency cesarean section to be done if it becomes necessary.

Just before the procedure an ultrasound will be done to confirm the position of the baby and placenta. A nonstress test will be done to make sure the baby's heart rate is normal. You may be given medicine to relax your uterus. Sometimes you may be numbed with an epidural anesthetic.

You will lie on your back. Your healthcare provider will place his or her hands on your abdomen and find the baby's head. Your provider will then gently press on your abdomen to push the baby into a headfirst position.

What happens after the procedure?

After the procedure you will have another nonstress test to check the baby.

If the procedure is unsuccessful, your healthcare provider will discuss the risks and benefits of vaginal breech delivery compared with C-section in your particular case. Even if the procedure is successful, the baby could return to the breech position before you begin labor.

What are the risks associated with this procedure?

Some of the potential complications of this procedure include:

• premature labor
• premature rupture of the bag of waters
• damage to the placenta, possibly causing separation of part or all of it
• the need for an emergency C-section if there is a concern that the baby may not be getting enough oxygen, usually because of a pinched or twisted umbilical cord

The likelihood of these complications is small. However, any of these problems can be very serious. For this reason, many healthcare providers prefer not to do external cephalic versions.

When should I call my healthcare provider?

Call your provider right away if:

• You are leaking fluid from the vagina.
• You do not feel the baby moving.
• You have vaginal bleeding.
• You begin to have strong contractions.
• You have pain in your abdomen.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.