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Turning a Baby

When your baby is in the breech position

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Originally published in Today's Parent October 2003

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If your baby is in the breech position (head up, buttocks down) as your due date approaches, your caregiver may recommend a procedure known as external cephalic version (ECV), a manoeuvre used to move a baby into a head-down position. Eileen Hutton is a midwife and clinical researcher at the University of Toronto who has studied and performed ECV extensively. She notes that the procedure “is being looked at with new interest” these days. A recent Canadian trial which assessed the risks and benefits of breech birth versus Caesarean section was stopped midway, when it became evident that vaginal deliveries carried more risks than C-section for breech babies. Hutton recently released the results of a survey that showed very few doctors are comfortable with vaginal breech birth. So for women with a breech baby who wish to avoid a C-section, getting the baby to turn before labour commences may be the best option.

How is ECV done?
A midwife or doctor uses her hands to “lift” the baby’s buttocks out of the pelvis so that the baby is “floating.” This is often the most difficult part of the procedure since the baby’s buttocks may have settled well down into the pelvis. Pressure is applied to the baby’s head to get him to “somersault” forward into a head-down position. The baby’s heart rate is monitored during ECV, and sometimes women are given a drug to help relax the muscles of the uterus.

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