By the end of pregnancy, most babies are in the head-down position in the pelvis. However, 3 to 4% of babies are in the breech position. This means the baby’s head is at the top of the uterus, below the rib cage. The baby’s buttocks and/or feet are then at the bottom of the uterus, inside the pelvis at the pubic bone. An external cephalic version is intended to turn the baby.
Risks associated with breech births
Breech births have a higher risk of complications. Babies are often born in below average condition and frequently need to be admitted to the hospital’s neonatal ward. A breech birth is also more likely to require a caesarean section. This invasive surgery poses risks for both mother and child. An external cephalic version increases the chances of spontaneous cephalic repositioning so that the baby is head-down during childbirth and you do not have a breech birth or require a caesarean section.
External cephalic version
During the procedure, an attempt is made to externally and manually turn the baby from breech position to the head-down position. Prior to this, the midwife will provide a comprehensive explanation of the risks of the procedure, the risks if the baby cannot be turned, and the risks posed by a breech birth. We also provide you with written information to enable you to make a considered choice.
Checks ahead of external cephalic version
If you opt for this procedure, the exact position of the baby will be established by means of an ultrasound scan. We also examine the type of breech position; for example, with or without legs drawn in. In addition, we monitor the volume of amniotic fluid, the position of the placenta and any other details. We monitor and record the baby’s heartbeat via ultrasound scan or Doppler.
External cephalic version practitioner
The external cephalic version practitioner performs the procedure by placing both hands on the mother’s abdomen and around the baby and then, using light pressure, pushing the baby’s head and bottom in the desired direction. Another ultrasound is performed to check the position of the baby, as well as its heartbeat. If your blood group is Rhesus-negative, anti-D is administered.
Complications following external cephalic version
Complications after the procedure are rare. Sometimes, the baby has a somewhat slower heartbeat directly after the procedure, but normal rhythm usually resumes within 10 minutes. Your belly may feel somewhat sensitive and bruised the next day, but that is just temporary. However, if you experience loss of blood or amniotic fluid, you must contact us immediately. If the procedure fails, the baby will remain in breech position and we will then refer you to a gynaecologist.
Verloskundigen Amsterdam Zuid’s success rate with external cephalic version
External cephalic version is a safe method of reducing the likelihood of a breech birth. At the Verloskundigen Amsterdam Zuid practice, our success rate for this procedure in the past year was very high at 75%. The procedure is carried out using an ultrasound scan before and afterwards to monitor the baby’s position.
Making an appointment for external cephalic version
The cost of external cephalic version is fully insured and we can claim it directly from your health insurance provider. Please contact our assistants if you would like to make an appointment for an external cephalic version. The external cephalic version practitioner will first assess you, discuss the procedure with you and then provide you with written information. You can also find more information about the procedure on this site and in the External cephalic version and breech position brochure.