External cephalic version, or ECV, is a maneuver your doctor may use when your unborn baby is set up to come out bottom first or feet first. Those positions are called a breech birth, and they can make a vaginal birth more difficult. With an ECV, your doctor turns the baby into a headfirst, or cephalic, position toward the opening of the birth canal.

External Cephalic Version Procedure

It’s usually done by your obstetrician. Your baby’s heartbeat will be monitored for about a half-hour before the ECV. In some cases, you may get medicine through an IV to relax your uterus. This won’t affect your baby.

Then, by pressing their hands on the outside of your belly, your doctor will try to turn your baby. The goal is to get your baby to do a little flip in your womb and finish up head-down. This can take several hours.

Your doctor may use an ultrasound to check your baby’s position and guide the process.

Does ECV Hurt?

To turn your baby, your doctor will use firm pressure. Everyone reacts differently, so you might feel discomfort or pain. Many women go through an ECV without any painkillers. But your doctor may give you an epidural or other pain medication or even put you to sleep during the procedure.

External Cephalic Version Risks

An ECV isn’t right for you if you’re expecting more than one baby or you need a C-section.

It also works best on women with a pear-shaped womb and not those with a heart-shaped womb, called a bicornuate uterus.

Other reasons your doctor might tell you not to get an ECV are:

• You have vaginal bleeding within 7 days of the procedure.
• Your baby has an abnormal heartbeat or health problems.
• Your water has broken.
• Your baby is larger than average.
• Your amniotic fluid levels are too low or too high.
• Your baby’s head is hyperextended, meaning it’s straight instead of bending forward.
• You have a heart problem or other conditions that prevent you from receiving certain anti-contraction drugs to prevent placenta previa, which can cause severe bleeding during pregnancy and delivery