External cephalic version (ECV), also sometimes referred to just as version, is a procedure used to turn babies from a breech or side-lying position to a head-down position. If your ECV is successful, you may be able to have a vaginal birth rather than a scheduled caesarean. However, not all mothers with breech babies are eligible for an ECV. So when will you need an ECV? Due to the fact that around 90 percent of breech births are delivered via a caesarean section, according to a University of Michigan Health System study, ECV provides an alternative option to pregnant mothers with breech babies.
If you meet the selection criteria for an ECV, it should be performed in a hospital, where an emergency caesarean can be performed in case the ECV causes complications. Though complications are fairly uncommon (between one and two percent of ECVs experience complications, according to the American Academy of Family Physicians), it is important that the procedure is monitored closely, as attempting to relieve your baby from its breech position is no easy feat. Read on to find out if you're eligible for an ECV, and if you think you may be, discuss the procedure with your doctor as a possible alternative to a caesarean.
1. When You're Between 37 and 42 Weeks Pregnant
According to Parenting Weekly, ECVs are not attempted any earlier than 37 weeks, because the baby may revert back to the breech position before you go into labor. In fact, about four percent of fetuses return to a breech position after a successful ECV, which is why the timing of an ECV is so important. Another reason doctors wait to assess the possibility of an ECV until 37 week, is because most babies rotate to the proper position on their own by the 37th week.
2. When There's Enough Amniotic Fluid To Turn The Fetus
One of the most important parts of ECV selection criteria is determining if you have enough amniotic fluid to turn the fetus, according to WebMD. If the amount of amniotic fluid is below normal, your fetus is more likely to be injured during an ECV attempt.
3. When You're Pregnant With One Fetus
ECV will not be attempted if you are carrying more than one baby, according to the American Congress of Obstetricians and Gynecologists. Because the rotation of one fetus is such a delicate matter, and so many things need to be in place before an ECV can even be considered, attempting an ECV with two babies would raise complication levels and put both fetuses at a very high risk.
4. When The Fetus Has Not Engaged Yet
If the fetus has not engaged yet, you may be eligible for an ECV, according to WebMD. However, if the fetus has engaged (dropped into the pelvis), the fetus will be very difficult to move, and ECV success rate goes down.
5. When You've Been Pregnant Before
ECV is more likely to work if this isn't your first pregnancy, according to Baby Center. Because your uterus stretches during pregnancy, if you've been pregnant before, your uterus is more flexible, and easier to shift your breech baby around in, according to WebMD. Though if you have not had a baby before, you may still be eligible for an ECV.
6. When You & Your Baby Are Healthy
If your fetus is known or suspected to have a birth defect, or if you've had a high risk pregnancy, an ECV is an unlikely option for you, according to the American Academy of Family Physicians. Because you or your fetus are already in a delicate state, introducing an ECV to shift your baby in utero can induce an early labor if either of you have previous complications.
7. When You Haven't Gone Into Labor Yet
ECVs are usually performed before labor begins, because once you go into labor, your uterus is contracting. According to a study done by the University of Michigan Health System, ECVs are avoided once a mother goes into labor, because a tense or contracting uterus significantly reduces the success rate of an ECV. If your baby is breech, and you think you may be eligible for an ECV, discuss the possibility with your doctor, and see if an ECV is right for you.