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External Cephalic Version

This webpage will give you information about an external cephalic version. If you have any questions, you should ask your GP or other relevant health professional.

What is an external cephalic version?

An external cephalic version (ECV) is a procedure to turn a baby in the womb from breech (bottom or feet-first) to headfirst (see figure 1). 

A breech baby

An ECV is usually recommended if your baby is breech after 36 weeks (if this is your first baby) or after 37 weeks (if you have had a baby before). An ECV will give you the best chance of a normal vaginal delivery and is suitable for most women.

If an ECV is not suitable for you, you will need to consider either a Caesarean section (procedure to deliver a baby by a surgical operation) or a vaginal breech delivery. 

Figure 1: A breech baby 

Are there any alternatives to an ECV?

There is a type of heat therapy called moxibustion together with acupuncture that may help turn babies from breech to the head-first position. There is not yet enough evidence for your obstetrician to recommend this technique above an ECV.

What does the procedure involve?

The procedure usually takes about fifteen minutes. Your obstetrician will carefully push on your abdomen to try to turn your baby into a headfirst position. They will monitor your baby’s heartbeat regularly to check that it is normal. Your baby’s heartbeat will be monitored for up to 45 minutes after the procedure.

What complications can happen?

  • Bleeding from the placenta
  • Change in the baby’s heartbeat
  • Distressed baby

What happens if the ECV is not a success?

Your obstetrician may be able to perform another ECV or you will need to consider either a Caesarean section or a vaginal breech delivery.


An ECV is usually a safe and effective way of turning your baby from breech to headfirst.


Author: Dr Lucy Kean DM MRCOG and Dr Alison Crocker BM BCh (Oxon)

Illustrations: Medical Illustration Copyright © 2011 Nucleus Medical Art. All rights reserved.

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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