External Cephalic Version (ECV): Should I do one? The Difficulties of Answering this Question.

An ECV can look like turning a baby with two fingers while supporting the baby with some follow-through, or it can look like 2 providers with their full weight of their bodies pushing on the belly.  These two experiences are called the same thing, yet they aren’t for the person carrying the baby.  This spectrum is why some people say it isn’t a big deal and others say they wish they’d never done it.  Research shows that people are more at peace with an ECV when it works.  If it doesn’t work, there can be mixed feelings.  Some feel good that they “did everything they could.”  Others feel mixed emotions and sometimes trauma.  Someone who has access and interest in a vaginal breech birth may or may not choose to do an ECV.

So what are the nuances:

  1. Is this a subsequent pregnancy? (Probably easier)
  2. Is the baby deep in the pelvis?  (Possibly harder if you aren’t able to get them out first)
  3. Is this baby literally jammed under the rib? (How creative are they going to be – possibly harder, try lateral side lie and softening under the rib they are typically under)
  4. Is there an anterior placenta or placenta in front of baby’s head? (Possibly harder)
  5. Is there scar tissue from abdominal surgeries reducing space? (Possibly harder but possible release of space with fascial bodywork over the back and belly too)
  6. Do you have a specially shaped uterus such as bicornate, unicornate, arcuate, or septum? (Probably harder but there are spectrums of these too, some can be late and others be proactive earlier)
  7. Do you have low fluids? (Probably harder, drink some fresh coconut water)
  8. Do you have high fluids? (Probably easier but potential for instability, get some bodywork)
  9. Do you have a pocket of fluid in front of the head? (Probably easier, if not get some bodywork)
  10. Do you have a long torso? (Probably easier)
  11. Do you have box-shaped ribs that extend down to the top of your hip? (Possibly harder)
  12. Is your baby “large” or especially late in gestation? (Possibly harder but not the breaking point)
  13. Is your baby small or are you earlier in gestation? (Possibly easier but not the breaking point)
  14. Do you have tight abdominal muscles? (Possibly more difficult, but soften and relax with body work)
  15. Do you feel safe and comfortable with your provider? (Possibly easier).
  16. Is your baby a complete breech or footling breech? (Possibly easier for head to tuck and back to flex)
  17. Is your baby RSA or RST? (Possibly easier)
  18. Have you previously been pregnant with twins? (Possibly easier but might be unstable afterwards)
  19. Are you at peace with a vaginal breech birth and have support? (It probably doesn’t matter)
  20. Is your ECV person skilled?  Do they do a lot of ECVs? (Probably more chances of success)
  21. Do you have large fibroids near the head? (Possibly harder)

…and there is probably more. 

Remember, baby has inside information. What are they telling us?  Are we listening? 

Other suggestions: soften with bodywork and balancing first, if baby is deep in the pelvis do a breech tilt beforehand, good deep breaths shift the space and pressures from within, relaxation and connecting to baby can be helpful for space too.

#ECV #Externalcephalicversion #breechpregnancy #shouldIdoanECV