External Cephalic Version

If your baby is breech, you may be offered an external cephalic version (ECV). This is when your obstetrician or midwife tries to turn your baby into a head-down position by applying gentle pressure on your abdomen.

If an external cephalic version is successful in turning your baby into a head-first position, it will increase the likelihood of normal vaginal birth.

What is external cephalic version?

An external cephalic version (ECV) is the process of turning a baby from a breech position, where they lie bottom-first or feet-first in your womb instead of the usual head-first position, to a head-down position.

It is usually done when you are 36 or 37 weeks pregnant. It is a safe procedure that involves applying gentle pressure on your abdomen to encourage the baby to do a somersault in your womb until they are facing head-first.

The aim of an ECV is to allow your baby to be born head-first as this increases your chances of having a normal birth.

Is an external cephalic version painful?

An external cephalic version can be uncomfortable.

If you find it painful you should let your obstetrician or midwife know. They can stop and move their hands to a more comfortable position for you.

If needed, the ECV can be stopped at any time.

How do I prepare for ECV?

You can eat and drink normally before you come to the hospital for your ECV appointment.

Before your ECV, you will have an ultrasound scan to confirm that your baby is still breech and a foetal heart rate trace to check that all is well with your baby.

You may then be given an injection to help to relax your womb while your baby is being turned. The head of the bed may be tipped down to help the baby’s bottom come out of your pelvis.

How is an external cephalic version done?

Your obstetrician or midwife will place their hands on your stomach and encourage your baby to turn in a forward or backward roll, with the aim of finishing in a head-down position. The procedure only takes a few minutes.

After the ECV, you will have another ultrasound scan and a further recording of the baby’s heart rate. If all is well, you can go home.

If you have a Rhesus negative blood group, you need to have a blood test, called a Kleihauer, to see if your baby’s blood cells have mixed with yours. If this has happened you will be given an Anti-D injection and you may need more Anti-D over the next three days.

What are the costs of an external cephalic version?

The costs of an external cephalic version will depend on whether you have a Rhesus negative blood group and require a blood test and additional Anti-D, and your Ramsay hospital of choice.

You will receive a formal quotation price after your consultation with one of our experienced obstetricians. This formal quote will be valid for 60 days.

We have a number of finance options if you are paying for your ECV yourself. These include:

  • Interest-free finance – requires no deposit and you can make monthly instalments at 0% interest.
  • All-inclusive Total Care – is a one-off payment at a pre-agreed price.
  • Pay as you go – a flexible funding option if costs are difficult to assess or you want to pay for your costs as and when they arise.

Ramsay is recognised by all major medical insurers. However, most insurance companies do not cover maternity care in the UK. If your insurance company is willing to cover your ECV, we advise that you obtain written confirmation from your insurance before proceeding.

What is the recovery process of an External Cephalic Version?

You should have no recovery after your ECV and continue your end of pregnancy as normal.

If you experience any problems such as bleeding, unusual pain or reduced movements from the baby after the procedure, you should contact your doctor immediately.

External cephalic version at Ramsay Health Care

External cephalic version is performed by experienced consultant obstetricians at Ramsay Health Care to try to turn your baby into a head-down position and improve your chances of normal birth. At Ramsay, we successfully turn a high percentage of babies.

Ramsay Health care will perform an ultrasound and foetal heart rate trace before your ECV to check your baby is still breech and that all is well with your baby. They will repeat this after your procedure to check if your baby has turned and to monitor your baby’s heart rate.


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