External Cephalic Version: Turning a Breech Baby

Most babies are in a head-down or vertex position just before birth making a vaginal birth usually safe and possible. Sometimes the baby will be in position with the buttocks or feet first in the mother's uterus. This is known as a breech baby or breech birth.

Many more complications can occur during a vaginal birth if the baby is breech. The umbilical cord can become pinched or crushed and cause asphyxia or even death of the baby and sometimes, even the mother. Generally breech babies are delivered by cesarean delivery, or c-section.

While risks are involved in cesarean deliveries such as bleeding, infections, added pain and discomfort from the surgical procedure and longer hospital stays for both the mother and the baby, another option may be possible: External Cephalic Version.

External cephalic version is a procedure to try to turn the baby inside the uterus from a breech position to the vertex or head-down position. The doctor will use his hands on the outside of your abdomen and push and roll to attempt repositioning the baby in a head-down position.

Version is generally done at the end of the pregnancy, after the 36th week of gestation, as there is a small risk of inducing labor with the procedure. Also, there is a chance of fetal distress leading to an emergency cesarean delivery. There is a chance, too, that the baby may turn back into the breech position after the external cephalic version procedure is done.

There are several conditions where a woman cannot have external cephalic version. These include the following:

If there is vaginal bleeding

If the placenta is near or covering the cervix

If there has been a nonreactive nonstress test

If the baby is abnormally small

If there is a low level of fluid surrounding the baby

If there is an abnormal fetal heart rate

If there are twins or other multiples

If there has been a premature rupture of the membranes