Patient Information
MATERNITY SERVICES
WOMEN’S, CHILDREN’S & SEXUAL HEALTH DIRECTORATE
External Cephalic Version
(ECV)
What is a breech presentation?
Breech means that your baby is lying bottom first or feet first in your womb (uterus) instead
of in the usual head first position. Between 37 and 42 weeks (term) most babies lay head
first, ready to be born. The incidence of a breech presentation at term is about 3-4%.
What is ECV?
This means turning the baby from bottom first to head first, in preparation for birth.
What are the implications of having a breech presentation?

Caesarean sections, though safe, carry risks for women during and after the
operation. There are also risks to mum and baby with any subsequent
pregnancies. Therefore a successful ECV then means a caesarean section
can be avoided.

Because of the risks associated with caesarean sections, Mid Essex offer
the choice of a vaginal breech delivery, but this is dependant on your
previous birthing experience.
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Patient Information
How is an ECV performed?

After having the discussion with the doctor in antenatal clinic you will be
admitted to Labour Ward at an agreed date and time. This will be after 36
weeks of pregnancy if it is your first baby and after 37 weeks if you have had
a baby before.

You are advised to have a light breakfast in the morning (7.00am) on the
day of the procedure, then nothing else to eat or drink until after the
procedure. We will make a note of your blood type.

The doctor will explain the ECV process to you and you will then be asked to
sign a consent form for the procedure.

If your blood is rhesus negative, then a precautionary injection of anti- D will
be given with your consent to you after the procedure.

A CTG (tracing of the babies heart beat) will be performed to ensure good
fetal health prior to the ECV.

We will then check the position of your baby using the ultrasound machine.

You may be given a small injection to help the womb relax to facilitate the
procedure. This medication may cause a rise in your pulse rate.

The doctor will then attempt the procedure using their hands on your tummy
to turn your baby.

Another CTG will be then be performed for at least one hour at the end of the
procedure to ensure your baby’s well being. You are advised to stay in the
maternity area for a further 2 hours before going home.
Does ECV always work?

ECV is successful for about half of all women (50%). Your obstetrician or
midwife should give you information about your own individual chance of
success.

Relaxing the muscles of the womb with medication during an ECV is likely to
improve the chance of success. This medication will not affect the baby. You
can help by relaxing your abdominal (tummy) muscles.

If the baby does not turn, it is possible to have a second attempt on another
day. If the baby does not turn after a second attempt, your obstetrician or
midwife will discuss your birthing options.
Can my baby turn back to breech after a successful ECV?
It is very unlikely that once your baby has turned to a head down position that it will turn
back to a breech position.
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Patient Information
Is ECV safe for me and my baby?
ECV is generally safe and does not cause labour to begin. Your baby’s heart will be
monitored before and after the ECV.
Like any medical procedure, complications can sometimes occur. About 1 in 200 (0.5%)
babies need to be delivered by emergency caesarean section immediately after an ECV
because of bleeding from the placenta and/or changes in the baby’s heartbeat. As a
precautionary measure this is why a light breakfast only is advised on the day of your
ECV.
What happens after the ECV?
If the ECV is successful, your antenatal care will be with your midwife unless indicated. If
the baby does not turn your obstetrician or midwife will discuss your options for birth.
You are advised to tell us if you experience pain in your tummy, bleeding or reduced fetal
movements. You can contact us by telephoning Labour Ward on 01245 513056/3057 or
the Day Assessment Unit on 01245 513355.
Contacts / Further Information
If you would like further information, regarding the evidence printed in this leaflet please
refer to either:
www.nice.org.uk
www.rcog.org.uk
or contact the Day Assessment Unit on 01245 513355 or the Antenatal clinic on 01245
513062 and ask to speak to the Antenatal Clinic midwife.
Please ask if you require this information in other languages, large print, easy read
accessible information, audio/visual, signing, pictorial and change picture bank format via
the Patient Advisory Liaison Service (PALS) on (01245) 514235.
Mid Essex Hospital services NHS Trust is smoke-free. You cannot smoke on site.
For advice on quitting, contact your GP or the NHS smoking helpline free, 0800 169 0
169.
Charitable donations can make a very real difference to the overall level of patient care at
our Trust. As well as contributing to new facilities, donations can be used to buy specialist
equipment and smaller items to make patient’s stay in hospital more comfortable. For
information about making a donation please contact the Charities Office on 01245 514559
or visit the website at: http://www.meht.nhs.uk/get-involved/
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Patient Information
Document History
Department
Published/Review:
File name
Version/ref no
Maternity Services
October 2014 / September 2017
External Cephalic Version (ECV)
2.0 / MEHT000279
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