'Manually' turning the baby?

[gloti]

Just came back from 36 weeks scan and my baby is breech the consultant said that he might turn still but that if he doesn't they will manually try to turn him, whatever that means!
I'm a little scared as I heard this might hurt... Does anyone know what they actually do and also does it always work?
Any advice/experiences appreciated x

Hi - not much experience, but I know the procedure is called ECV or External Cephalic Version (I think). They give you a muscle relaxant and then try to turn the baby from the outside, using lubricant.

In some cases, it's not advised as it can be risky - more so if you have an anterior placenta. You can refuse this, like anything else, but it may mean you are booked in for an ELCS instead. It's also worth asking for the individual consultant's sucess record before deciding.

There are lots of threads about this on here.

FX baby turns by itself...

I tried it ecv is the medical term. They do lots of monitoring of baby before and after so it takes most of the day. You can't eat or drink and you take your hospital bag just in case baby gets distressed and they want to whip them out, but this is extremely unlikely! You are given muscle relaxant and once it is working the consultant will firmly press onto your baby from the outside and try to push them round. Personally I found it quite uncomfortable and held dhs hand tight. My doctor had 3 goes taking a couple of minutes each time but it didn't work. I had a planned section instead a few weeks later which was fine. A good friend had it dkne successfully and had a straightforward natural birth.

I had this done. It hurts like your skin is being pinched between the baby and the person doing the turning but it is bearable. Baby monitored throughout. For me it worked perfectly and meant I could have a home birth. I would recommend doing it.

Didn't work for me, was a bit uncomfortable and a bit sore afterwards. Next time I'd probably go straight for a planned section (which is what I ended up with). Apparently only 10% or so will turn on their own after 34 weeks. I think.

Success depends on the kind of breech. Mine had straight legs so wouldn't really be able to kick himself round once moved, with bent legs it might be easier.

I had this done last week so thought I would chime in :)

The procedure is called External Cephalic Version (ECV for short) and people have different opinions on it including medical professionals. Some hospitals won't do it, some will. There are people who have found it very painful and others who have had virtually no pain. My mum had it done at 34 weeks with me successfully and it was very easy but I was quite small.

For a small percentage (around 1 in 1000 women) the procedure will cause them to go into labour and they need an emergency c-section. You are well monitored whilst the procedure is happening to make sure baby isn't in distress and if he is then it will be a section.

When I went to the hospital I was given a presentation scan by the midwives to see what position baby was in (extended breech for us). Then I went to labour ward which is where they do the procedure. I was hooked up to a monitor to do a trace of baby's heartbeat for 20mins. Bloods taken, blood pressure done as well. I was given an injection of turbutaline (unsure of spelling) to relax my uterus/womb.

Doctors then came in and explained what would happen. Two doctors put a lot of ultrasound gel on my tummy, checked where baby was with a scanner and then began the procedure. They were basically trying to pick baby up and turn him. It wasn't comfortable but was only for a few minutes at a time, they tried 3 times. I have quite a high pain threshold and just kind of get on with things so I zoned out staring at a mark on the ceiling, and breathing through it. It does feel quite invasive but nothing I couldn't handle (I know this will vary from person to person). I was 37 weeks.

The procedure didn't work. I felt very tender afterwards and for the next few days. I have been told it works in 50% of cases. Our baby is very stubborn! After it, I was scanned again to check baby and hooked up to a monitor again for half an hour to make sure baby wasn't in distress.

I was called the next day to be given the date of my c section.

Overall, I was glad I gave it a go. If you search for ECV on Mumsnet you will see different opinions. 10% of turned babies turn breech again after the procedure. Well, that's what I was told. Statistics probably vary.

You have the option to turn down the procedure if you aren't happy about having it. You can also have it done and stop halfway through if it's too uncomfortable.

There is a tiny risk of something going very wrong and losing your baby. It has happened to some women. It's whether you feel the risk is small enough to give the procedure a go.

I also have this issue - I am footling breech. It is worth knowing the certain types of breech should not be turned this way (like a star breech and some types of footling). It works in roughly 50% of cases - but the baby can of course turn back. It is worth remembering too that babys are breech for a reason (about 5% of babies end up breech) - i.e. not enough room within the fluid to turn on their own (hence why ECV can work) , or your uterus is a funny shape - think heart shaped, or lop sided heart- ECV would then not work (and no scan can tell them that). You have to think if you really care about a natural birth vs c section. And then weigh up the risks of c-section vs natural. Of course some breech can be delivered naturally (at least here in Germany they can) but footling breech, and star breech cannot. You are well within your rights to refuse it BTW. I will be refusing it, for what it is worth. But actually for me currently I would not be allowed it anyway based on her position. As other posters have mentioned, it can be fairly painless, down to absolute agony. Look at spinning babies for more info - and I post a further link below on ECV.

www.spinningbabies.com/baby-positions/breech-bottoms-up/about-breech

www.webmd.com/baby/external-cephalic-version-version-for-breech-position

here are some risks:-

Potential risks of version, for which the fetus and mother are closely monitored, include:

Twisting or squeezing of the umbilical cord, reducing blood flow and oxygen to the fetus.
The beginning of labor, which can be caused by rupture of the amniotic sac around the fetus (premature rupture of the membranes, or PROM).
Placenta abruptio, rupture of the uterus, or damage to the umbilical cord. The potential exists for such complications, but they are very rare.
In the rare case that labor begins or the fetus or mother develops a serious problem during version, an emergency cesarean section (C-section) may be done to deliver the fetus.

You could try moxibustion before you go for something more invasive like ECV. My yoga teacher raves about this! Google it.

As someone mentioned, it's a long day! DS was stuck fast with his bum right in my pelvis and his head under my ribs, the consultant didn't think it worth the relaxant as he was going nowhere. So we left with the ELCS booked for the following week.

He had to go for hip scans due to his position, but he was fine, and had freakish head control from a few days old!

Lots of luck, congrats!

There are loads of videos of women having ECV on YouTube which are worth a look before deciding for yourself whether you fancy it.

Wow thank you so much everyone I didn't expect so many responses... I think I'll go away now and do some research before I see the MW on Thursday...

I was told today that my baby is big (already 3.3kgs at 36 weeks) not sure if that will affect the success of the procedure!

Thanks again

Hi gloti - I'm currently considering whether I'm willing to have an ECV as my baby was breech at 34 weeks and my midwife isn't sure if he's turned or not. In for a scan tomorrow and will need to make the decision then.

There are lots of useful links to research papers, if you're that way inclined, at: evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/

In poking into some of these and some other papers it seems versions are less likely to work if: it's a first baby, it's a large baby, it's in the frank breech position (legs straight with feet near head), you have an anterior placenta, you had a pre-pregnancy BMI > 25, you have a lower then usual amount of fluid around the baby.

But I'm by no means an expert, so please take all this with a grain of salt! I'll be discussing it all with the consultant tomorrow if my scan shows the wee man hasn't flipped round yet.

Good luck.

Thanks HJbeans... I seem to tick a few of those boxes so might no go ahead with it... Will def read the papers you suggest. Thanks a lot and good luck tomorrow! X

Had my first baby turned around 14 years ago, and I didn't want to have it done ever again. Baby 2 and 3 were breech until 38 weeks and turned n their own. And they were big babies, very big.
There was a reason why they were breech until the end.

Thanks!

I tick all of those boxes but one, so suspect the chance of it working for me is much less than the ~50% average everyone talks about. The risk of complications are extremely low, though, so both MW and consultant are urging us to try it, more and less gently respectively.

For me it's likely to come down to i) whether I've correctly understood the stuff above; ii) the track-record of the person doing the ECV with my particular arrangement of baby and placenta; iii) whether I can stomach the fact that all the (admittedly very unlikely) risks are to the baby rather than to me. I don't care all that much about having a natural birth, so am probably leaning toward declining the ECV but am open to convincing.

Hope your little one flips for you.

My sons 3 now, but when I was around the 35 week mark of pregnancy, I had a midwife appointment just to check the position of him.
The midwife did this procedure (externally I might add) without asking! As a first time mum to be I had no idea what the heck she was doing. I didnt even realise it had a name until I read this thread. She just said 'let's see if I can move him round abit for you'. I've just looked at the YouTube videos of it and it looks exactly like what she did.
It flippin hurt and I'm quite shocked that she didnt talk to me before she did it.

I post this on all ECV threads I see. This procedure is not even offered in the country where I live due to risks to the baby.
Babies have unfortunately died after having this procedure, if you search the forums I think there was a mums netter who sadly lost her baby in this way.
I am shocked that a midwife would do this procedure without even telling the mother!!

Just to say I have consultant led care (because Ivan expecting twins) and he has mentioned to me before that he does not perform this procedure because of the, in his opinion, unacceptable and avoidable risks to the baby. He is very pro c sections though, and considers that c sections should be offered in all but routine, very low risk situations. He has been a fab consultant to be (all new to me - I have a DD who was totally midwife led care / natural birth with g and a only efc), so I respect that when he says there are risks, there are risks that I would prefer to avoid!

I must agree with legally on this one - because I should also add I know a couple of doctors with breech babies, and they all flatly refused the procedure based on the risks. My Gyn. here has never even suggested it - it was my midwife, who was rather 'Meh' about it and thinks for most people it isn't worth it, although for some it can work very nicely, like I myself was turned by this method over 30 years ago (!) but this was by my mums private Gyn. who was very very experienced, and I do think since I am a second baby it is easier - for first babies it is less successful I believe. At the end of the day - you can perfectly refuse if you want, or if you go ahead stop them AT ANY POINT during xx

My little guy has just been confirmed flipped at 36 weeks, so late flips do apparently happen. Happy not to have to make the decision on the ECV. Good luck to you, gloti.

All well done that's a relief! I'm seeing the MW tomorrow to go through the big baby concerns so she will hopefully check for position too... Fingers crossed and thanks to everyone who replied, I think if he's still breech I will refuse this procedure...

I was booked in for ECV when pg with DC2 but they scanned me beforehand and she'd turned on her own.

Ds2 turned very late from head -down to breech. I was very unsure about ecv but keen to have a natural birth as I already had ds1 at home who was only 1 1/2 and i was keen not to have to stay in hospital. I had the ecv which was successful and really not painful for me at all. Btw ds2 was 8lb11oz so not a small baby.