As pregnancy progresses, most babies naturally settle into a head-down position, preparing for birth. However, in some pregnancies, the baby remains in a breech position with the feet or bottom facing down instead of the head. When this happens close to delivery, one medical option doctors may suggest is External Cephalic Version (ECV).
Understanding ECV can help women make informed, confident decisions about their childbirth options.
What Is External Cephalic Version?
External Cephalic Version, commonly called ECV, is a medical procedure in which a trained healthcare provider uses their hands on the mother’s abdomen to gently turn the baby from a breech or sideways position into a head-down (cephalic) position.
The procedure is usually performed around 36–37 weeks of pregnancy, when the baby is mature but still has enough room to turn.
Why Is ECV Recommended?
A head-down baby increases the chances of a safe vaginal delivery. Breech babies are more likely to require a caesarean section (C-section), which comes with longer recovery times and additional surgical risks.
ECV may help:
- Reduce the likelihood of a C-section
- Increase the chance of vaginal birth
- Avoid complications associated with breech delivery
How Is the Procedure Done?
ECV is typically performed in a hospital setting where both mother and baby can be closely monitored.
The process usually involves:
- An ultrasound to confirm the baby’s position
- Monitoring the baby’s heartbeat before and after the procedure
- Sometimes giving medication to relax the uterus
- The doctor applying firm but controlled pressure on the abdomen to guide the baby into position
The procedure usually lasts a few minutes.
Does ECV Hurt?
Experiences vary from woman to woman. Some describe ECV as uncomfortable or painful, while others report only mild pressure. Healthcare providers are trained to stop if the woman is in significant pain or if the baby shows signs of distress.
Pain relief options may be discussed beforehand.
How Successful Is ECV?
Success rates range between 40% and 60%, depending on factors such as:
- Whether this is a first pregnancy
- The amount of amniotic fluid
- Placenta position
- Baby’s size and flexibility
If successful, many women go on to have normal vaginal deliveries.
Is ECV Safe?
ECV is generally considered safe when performed by experienced professionals in a proper medical setting. Serious complications are rare, but may include:
- Temporary changes in the baby’s heartbeat
- Premature rupture of membranes
- Placental issues (very rare)
For this reason, ECV is done in facilities equipped for emergency delivery if needed.
Who Should Not Have ECV?
ECV may not be recommended if:
- The placenta covers the cervix (placenta previa)
- There are multiple pregnancies (twins or more)
- The baby has certain health conditions
- There is low amniotic fluid
- Vaginal delivery is not medically advised
Your doctor or midwife will assess whether ECV is safe for you.
What Are the Alternatives?
If ECV is unsuccessful or not advised, options may include:
- Planned C-section
- Vaginal breech delivery (in carefully selected cases with experienced providers)
- Waiting for spontaneous turning (less likely late in pregnancy)
Making the Right Choice
Every pregnancy is unique. Choosing whether to attempt ECV should involve open discussion, clear information, and respect for the mother’s comfort and wishes.
At Just4WomenAfrica, we believe women deserve knowledge, choice, and support throughout pregnancy and childbirth.
If you have concerns about your baby’s position, speak with a qualified healthcare professional to explore your options.
