What is an external cephalic version, and is it safe?

| Jun 16, 2021 | Birth Injuries |

If, in your final weeks of pregnancy, your doctor tells you that your baby is in the breech position, you, understandably, may have several questions. One of the first two that may pop into your mind may be, “What does ‘breech’ mean, and is delivery safe?” A third question to closely follow might be, “What can your doctor do about it?”

In a normal pregnancy, the fetus moves into a position in which he or she prepares to come head-first out of the vagina. In a breech pregnancy, however, the fetus’s feet, buttocks or both are positioned to come out first. Breech positions occur in 3% to 4% of pregnancies and can pose a few complications for both baby and mother. To prevent complications, your doctor may try to treat the breech position via an external cephalic version.

What is external cephalic version?

Per The American College of Obstetricians and Gynecologists, an ECV is a procedure in which your doctor will attempt to reposition the fetus so that he or she is headfirst. This procedure is safest to perform around 36 weeks. Though a non-invasive procedure that typically involves two people pushing down on your abdomen to reposition the fetus, it can result in complications. The most common complications of an ECV are as follows:

  • Changes in the fetus’s heart rate
  • Placental abruption
  • Pre-labor rupture of membranes
  • Premature birth

Your doctor should prepare for these risks and only perform an ECV when you are close to a labor and delivery room. If problems arise, your doctor should order a cesarean section immediately.

How successful are ECVs?

More than one-half of ECVs prevent breech deliveries. However, it is not uncommon for fetuses of successful ECVs to turn back into breech position. In this case, the doctor may perform a second ECV, though the risks associated with the procedure increase during subsequent attempts.

When will your doctor not order an ECV?

There are some situations in which your doctor may decide that performing an ECV comes with more risks than not. Some such instances include if you are carrying multiples, if your doctor has concerns about the health of the fetus, if the placenta is in the wrong place or detached from the wall, and if your reproductive system has known abnormalities.

If your baby sustained birth injuries during a breech pregnancy, or if your doctor performed an ECV despite known risk factors, you may feel angry and as if your doctor violated your trust. If this is the case, it may help you to understand your legal rights.

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