If your baby remains in the breech position by late pregnancy, your doctor can try to turn the baby by hand. This procedure is called external cephalic version (ECV).
During ECV your obstetrician places firm but gentle pressure on your tummy to encourage your baby to turn a somersault in your womb (uterus). Your baby will then be head-down. ECV works for roughly half of the women who have it.
The procedure will be carried out in hospital, where there is equipment to monitor your baby's heartbeat and ultrasound to check your baby's position.
Your doctor will offer you medication to make the muscles of your womb relax. The medication won't affect your baby. If you are rhesus negative, you will have an injection of anti-D.
You won't need to have a general anaesthetic. The procedure may be a bit uncomfortable for you, but it shouldn't harm you or your baby. ECV is considered to be a safe procedure and complications are uncommon. There will be a theatre nearby, just in case you need an emergency caesarean immediately afterwards. This could be because of bleeding or reduced fetal movements, and happens in about one in 200 ECVs. After the procedure, you'll be able to return home.
ECV is more likely to be successful if:
you've had a baby before
there is plenty of fluid around your baby
your baby is high up and has not yet engaged in your pelvis
a drug is used to relax the muscles of the womb
ECV should not be offered to you if:
You're expecting twins or more. The exception is during the pushing stage of labour, if you've given birth to the first baby and your next baby needs to be turned to be born.
You've had vaginal bleeding in the past week.
Your womb is heart-shaped, rather than pear-shaped.
Your baby's heart rate isn't normal.
Your waters have broken.
If the first attempt at ECV is unsuccessful, your doctor may suggest trying again on another day, if he thinks it's right for your pregnancy.
Bear in mind that even after a successful ECV, your baby may decide to turn round again! Less than five per cent of babies turn back to breech position. Your doctor may then recommend that you give birth by caesarean section. However, it may still be possible for you to give birth to your breech baby vaginally.
Most breech babies in the UK are born by caesarean as many experts consider this to be the safest way for breech babies to be born.
Whether you are offered a caesarean depends on:
Whether you opt for an ECV and whether it’s successful or not.
The exact position of your baby if she stays in the breech position, and your preferences.
The resources and experience of the midwives and doctors working at your maternity unit.
You may be advised to have a caesarean if:
Your baby's foot or feet are below her bottom (footling breech), or in a kneeling position (kneeling breech), though these positions are uncommon.
You’re expecting twins and the first twin is breech..
You have pre-eclampsia or another condition that means the health of either you or your baby is at risk.
Your baby’s estimated weight is more than 4kg (8lb 13oz) .
Your baby’s estimated weight is less than 2kg (4lb 6oz).
Your baby is in a certain position, such as a very tilted back (hyper-extended) neck, as this can make delivery of the head more difficult.
You’ve had a previous caesarean birth.
You’ve been clinically diagnosed with a narrow pelvis.
You have a low-lying placenta.