In most pregnancies, babies naturally move into a head-down position between weeks 32–38 of pregnancy. About 3–4% of babies remain in a breech position (bottom or feet down) near the end of pregnancy.
Your healthcare provider will usually check your baby’s position during late pregnancy visits by feeling your abdomen.
Even if your baby is breech earlier in pregnancy, many babies turn on their own before delivery. If your baby is still breech later in pregnancy, your provider may offer an external cephalic version (ECV) if you choose to try it.
When is an ECV performed?
An ECV is usually performed around 36–37 weeks of pregnancy. During the procedure, an OB-GYN uses their hands on the outside of your abdomen to try to gently turn the baby into a head-down position.
An ECV works in about half of cases, although success rates depend on several factors, including:
- the baby’s position
- the amount of amniotic fluid
- placenta location
- whether you have had previous pregnancies
What happens during an ECV?
Before the procedure:
- an ultrasound is performed
- your baby’s heart rate is monitored
- your provider evaluates the baby’s position and placenta location
You will usually receive medication to help relax the uterus. This medication may temporarily cause:
- shakiness
- feeling warm
- a racing heartbeat
These side effects are common and typically wear off quickly. Your provider then uses firm pressure on your abdomen to try to guide the baby into a head-down position. The procedure itself usually lasts only a few minutes.
What happens afterwards?
After the procedure:
- your baby’s heart rate will be monitored again
- another ultrasound may sometimes be performed
Most people can go home the same day. Complications are uncommon, but contact your healthcare provider immediately if you experience:
- vaginal bleeding
- severe abdominal pain
- contractions
- decreased fetal movement
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