You may be a loving mother in the last few weeks of your pregnancy. Every time you go for a scan to see your baby, you have high hopes. But suddenly the doctor says, "The baby is in a breech position." That means the baby's head is up and the bottom is down. This is what we call a ``breech position.'' It's normal to feel a little scared and worried at a time like this. You may be thinking, "Oh, will I have to have a cesarean section now?" But don't worry. Sometimes, there is a way to try to turn the baby before going for surgery. That's what we're talking about today.
Simply put, what is External Cephalic Version (ECV)?
External Cephalic Version, or ECV as we call it for short, is a procedure where the doctor places his hands on your belly and applies very careful and precise pressure to turn the baby inside the womb from a ``breech`` position to a ``head-down`` position. To be precise, this is where the baby is turned so that the head is down.
Think about it, around 36 weeks into your pregnancy, most babies naturally turn head down. This is the best and safest position for a vaginal delivery. But not all babies turn that way. Roughly speaking, about 3 out of 100 babies can still be in the breech position at this point. That's when your doctor will suggest an ECV. This is usually done around 37 weeks into your pregnancy.
How do you do this? Does it hurt?
This may sound a little scary to you. It's normal to have a lot of questions coming to your mind, like, "Oh, will it hurt if I press on the belly and turn the baby? Will it hurt the baby?" Let's see how this actually happens.
This procedure is performed by your obstetrician.
1. Preparation: First, your and your baby's health will be carefully checked. Things like the baby's heartbeat will be monitored.
2. Uterine relaxation: Often, you will be given a medicine to relax the muscles in your uterus. This will make it easier for the baby to turn and will also reduce the discomfort you feel.
3. Turning the baby: Next, the doctor will place his hands on your belly and apply steady, even pressure to gently turn the baby. This pressure will last for several minutes.
4. Monitoring: Even after turning the baby, things like the baby's heartbeat are monitored again to make sure the baby is doing well.
The most important thing is that nothing is put inside your vagina during this process. Everything happens over the belly.
Speaking of pain, yes, when you apply pressure to your stomach, you may feel some discomfort, tightness, like menstrual cramps. But it's not unbearable pain. Some doctors also prescribe painkillers, but that's not essential.
The entire procedure, including the tests, can take about two hours. For safety reasons, this is usually done in a place near an operating room. This is because if there is a sudden complication, an emergency C-section can be performed quickly. This is a precautionary measure, not a guarantee that such a thing will happen.
What are the benefits and risks of ECV?
Like any medical procedure, ECV has its benefits and some very minor risks. Your doctor will explain these to you in detail. Let's understand this clearly.
| Benefits | Risks |
|---|---|
| The main advantage is the increased chance of a vaginal delivery. Many mothers prefer to have a vaginal delivery rather than a cesarean section. If ECV is successful, you will have that opportunity. | Remember that these risks occur very rarely . |
| Avoiding a cesarean section (C-section). A cesarean section is a major surgery. It has associated risks and a long recovery time. ECV can prevent this. | - Premature rupture of the membranes: `(Premature rupture of the membranes)` - Placental abruption: `(Placental abruption)` - Early onset of labor: `(Preterm labor)` - Discomfort in the baby: Abnormal heartbeat of the baby (Fetal distress) - Vaginal bleeding: `(Vaginal bleeding)` |
The safety of you and your baby is always the most important thing, so your doctor will talk to you about these risks and help you decide if this is right for you.
Can everyone do this ECV?
No. Not every pregnant woman can do this. There are some situations where an ECV cannot be done, meaning it is not recommended. Your doctor will decide whether this is safe for you based on your medical history.
| When ECV is not recommended |
|---|
| - If you are having multiple babies, like twins . |
| - If you have recently had vaginal bleeding . |
| - If the amount of amniotic fluid around the baby is low . |
| - If the baby's heart rate is abnormal . |
| - If you have `Placenta Previa` (a condition in which the placenta is located at the bottom of the uterus and covers the cervix). |
| - If your uterus is abnormally shaped . |
| - If you have uncontrolled health problems, such as high blood pressure or diabetes. |
| - If you are scheduled to have a cesarean section anyway for another medical reason. |
What are the chances of ECV being successful?
This is a question that many people ask. The average success rate for an ECV is about 58% . That means that less than one in every two ECVs performed is successful. While this is not a 100% guarantee, it is a good opportunity to try for a normal delivery.
What happens if the ECV is not successful?
Imagine that your doctor has tried but failed to turn your baby. If that happens, there is no need to panic. As a next step, your doctor will talk to you and schedule a planned C-section at a later date . Very rarely, some experienced doctors are able to deliver a baby in a breech position vaginally. But it depends on many factors, including your and your baby's health and the doctor's experience. The final decision always comes down to your safety.
Remember, your plans for your delivery may change, but the most important thing is that the doctor's first and only goal is to deliver a healthy baby to a healthy mother.
Therefore, discuss all your concerns and fears with your doctor. Understand the process, its pros and cons, and make the best decision together.
Take-Home Message
- External Cephalic Version (ECV) is a safe medical procedure in which a breech baby is turned head down by rotating the hand over the abdomen.
- The main advantage of this is that it avoids a cesarean section and increases the chances of a normal vaginal delivery.
- The success rate of ECV is over 50%, which means it's worth trying.
- This is not suitable for every mother. Your doctor will decide whether this is suitable for you.
- Always be open with your doctor about any questions or concerns you may have regarding this. Your safety and that of your baby are the most important thing.
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