External cephalic version
An external cephalic version (ECV) is the process of turning a baby from a breech position to a head-down position by manipulating the baby from the outside of the abdomen.
Around 30 weeks of pregnancy, approximately 25% of babies are in a breech position. A large number of these will naturally turn to a head-down position. By 35-36 weeks, about 3% of babies remain in a breech position. Is this the case for you? If so, your midwife will explain the external cephalic version (ECV) procedure to you and, if desired, schedule an appointment with our dedicated version team. This team consists of Annemarijn Verbiest, Carmela Tilma-As, Hanneke Wijma, Imke van Soest, and Martine Wassenaar. They are specialists in performing ECVs and are registered in the national version register.
Martine Wassenaar
Annemarijn Verbiest
Carmela Tilma-As
Hanneke Wijma
Imke van Soest
Risks
The external cephalic version
During an external cephalic version (ECV), the baby is manually turned from a breech position to a head-down position by applying pressure externally with the hands. Before proceeding, the midwife will thoroughly explain the risks associated with the version, the potential risks of the breech position if it cannot be turned, and the implications of a breech delivery. We will also provide written information to help you make an informed decision.
If you choose to proceed with the ECV, an ultrasound will first be used to determine the baby’s exact position. We will also assess the type of breech position, such as with extended or flexed legs. Additionally, we will check the amount of amniotic fluid, the location of the placenta, and any other particularities. The baby’s heartbeat will be monitored and recorded using ultrasound or a Doppler device.
The version specialist
The version specialist performs the external cephalic version (ECV) by placing both hands on the abdomen to gently grasp the baby and apply light pressure to guide the baby’s breech and head into the desired position. After the procedure, an ultrasound is used to verify the baby’s position and check the heart rate. If you have a Rh-negative blood type, you will be given an anti-D injection to prevent complications related to blood group incompatibility.
Complications
Complications after an external cephalic version (ECV) are very rare. Occasionally, the baby may have a slightly slower heart rate immediately following the procedure, but this usually returns to a normal rhythm within 10 minutes. Additionally, the abdomen may feel tender or bruised the next day, but this is temporary. However, if you experience any bleeding or loss of amniotic fluid, you should contact your midwife immediately.
If the version is unsuccessful and the baby remains in a breech position, you will be referred to a gynecologist for further consultation and management.
Success rate at The Lekbrug
The version is a safe method to reduce the risk of breech birth. In our practice, the success rate over 2023, was 57%. (Nationally this 2021/2022 is 54%)
Cost
The costs of an external cephalic version (ECV) are fully covered and can be directly billed to the health insurance provider by us
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