What is external cephalic version for breech position?

You might choose to have your baby turned if you'd like to have a vaginal delivery.

Doctors may try to turn a baby when:

• The mother is 36 to 42 weeks pregnant. Before 36 weeks, the baby is likely to turn back into a head-down position on its own. But turning the baby may be more successful if it is done as early as possible after 36 weeks. That's because the baby is smaller and is surrounded by more amniotic fluid and space to move in the uterus.
• The mother is pregnant with only one baby.
• The baby has not dropped into the pelvis (has not engaged). A baby that has engaged is very hard to move.
• There is enough amniotic fluid surrounding the baby for turning the baby. If the amount of amniotic fluid is below normal (oligohydramnios), the baby is more likely to be injured during a version attempt.
• The mother has been pregnant before. A previous pregnancy usually means that the wall of the belly is more flexible and can stretch when the doctor tries to turn the baby. But version may also be tried if the mother hasn't been pregnant before.
• The baby is in the frank, complete breech, or footling breech position.

Version is usually not done when:

• The bag of waters (amniotic sac) has ruptured.
• The mother has a condition (such as a heart problem) that prevents her from receiving certain tocolytic medicines to prevent uterine contractions.
• A cesarean delivery is needed. This can happen when the placenta partially or completely covers the cervix (placenta previa) or has separated from the wall of the uterus (placenta abruptio).
• Fetal monitoring shows that the baby may not be doing well.
• The baby has a hyperextended head. This means that the neck is straight, rather than bending the head forward with the chin tucked into the chest.
• The baby is known or suspected to have a birth defect.
• The mother is pregnant with more than one baby (twins, triplets, or more).
• The mother's uterus does not have a normal shape.

Version may pose a slight risk of opening a previous C-section scar. Limited research has shown that women with a cesarean scar have had no such problems. But larger studies are needed to fully assess the risk.

In some cases, a doctor will choose not to try a version when there is less amniotic fluid than normal around the baby.

• Your doctor will give you medicine to relax your uterus. Your doctor may give you medicine for pain and to help you relax.
• Your doctor will put both hands on your belly. One hand will be near the baby's head. The other hand will be near the baby's rear end. The doctor will push and roll the baby to try to get the head down.
• You may feel some pain. The doctor will ask you how you are doing.
• Your doctor will use a heart monitor to see how your baby is doing.
• After the process, your doctor will give you instructions for your care.