External Cephalic Version (ECV) means turning the baby to a headfirst position while it is still in the womb. The aim is to turn the baby so you can have a normal vaginal delivery and the difficult decisions about breech delivery can be avoided.

At 28 weeks of pregnancy about 20% of babies will be in the breech position. Most babies turn spontaneously to the normal head first position, with only 3% remaining breech by 37 weeks of pregnancy.

If your baby is breech after 37 weeks you will be offered ECV. This reduces the risk of a caesarean section without any increased risk to the baby.

We offer all women with a baby in this position an ECV unless they have any of the following:

• low lying placenta (placenta praevia)
• vaginal bleeding
• a low level of fluid in the sac that surrounds and protects the baby
• a particularly small baby 
• an abnormal fetal heart rate
• previous caesarean section

The risks of ECV are very small. 50% of babies we turn this way stay head down for labour and some babies just don’t want to turn when we try. Here are some of the reasons why ECV may not be successful:

• Rarely the baby can be distressed. If this persists we can immediately transfer to Maternity theatre and perform a caesarean section. This happens in less than 1% of cases.
• One in a hundred times doing the procedure may make labour start.
• Again, one in a hundred times the waters may break. Your baby is mature and ready to be born so there is no additional risk.
• Very rarely there may be a small blood loss.  

You will be given an appointment for ECV at the Maternity Assessment Unit. You will be in the Unit for about three hours.

Please have nothing to eat or drink from midnight on the day of the procedure. When you arrive we will give you medication to help relax your uterus and make it easier to turn the baby.

The baby’s heart rate will be monitored before and after the procedure. Very occasionally a vaginal examination may be needed.

When we start to turn the baby you will be aware that the procedure is uncomfortable but not painful. We will always stop if you are too uncomfortable.

If the ECV is unsuccessful there is no benefit in trying again later in the pregnancy. Instead, we will arrange an antenatal clinic appointment with your consultant or a senior member of their team. At this appointment you will be able to discuss the best way for your baby to be born and make a plan for the remainder of your pregnancy.