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What Is an External Cephalic Version?

What It's Really Like to Have an External Cephalic Version

When I found out I was pregnant with my second child, I thought I knew what I was getting myself into. I had done the whole pregnancy thing before and I figured everything would be about the same. Boy, was I wrong. Everything was different. My morning sickness was much worse, I had crazy back pain, and my baby settled into a very comfortable transverse (sideways) position in my uterus pretty early on.

My midwife said it's pretty common for babies to be transverse during a second (or third, or fourth) pregnancy because the uterus is stretched out from previous pregnancies, making it easier for baby to find a comfy spot. I tried just about everything to get my baby to turn head down — I did handstands in the pool and even laid upside down off the edge of my couch on an ironing board. Nothing worked, so when I went in for my 38-week check up, my midwife gave me a few options. I could wait for labor to start and see if my baby turned head down or she could attempt an external cephalic version (ECV, for short), a procedure where your practitioner attempts to manually turn your baby into the correct position for labor and delivery.

I wanted to try everything I possibly could to get my baby head down, so they scheduled the ECV for the very next morning, when I was exactly 39-weeks pregnant.

We went home and packed our hospital bags, knowing there was a chance we may be having a baby the next day, depending on how the procedure went. We knew, at the very least, we would be there for a few hours so they could monitor the baby before and after the procedure. I was also told not to eat or drink anything after midnight, so I sent my husband out for ice cream before we went to bed.

The next morning, we headed to the hospital bright and early. I changed into my lovely blue hospital gown and my nurse attached a heart rate monitor to my belly. Various nurses and technicians came into my triage room to draw blood, insert my IV port, and check my blood pressure. There is medicine they can give you to help relax your uterus, but my doctor told me I didn't need it because I wasn't having strong contractions at the time. I didn't feel any contractions at all, actually, but the monitor was picking up some small ones. After an hour of monitoring, my doctor, midwife, and a midwifery student came into my room to perform the ECV.

He told me I would feel a great deal of pressure, but to try and breathe through it.

Before trying to turn the baby, they performed one more quick ultrasound to confirm the baby's position. My doctor did his best to prepare me for what was to come. He told me I would feel a great deal of pressure, but to try and breathe through it. With my doctor on one side, and my midwife on the other, they told me to take a deep breath and gave me a quick 3-2-1 countdown.

As my doctor began to push the baby's head down and my midwife pushed the rest of the body up, I felt the most intense pressure I have felt in my life. I wouldn't describe it as painful, but the pressure was almost too much to bear. I could not believe they could push that hard without hurting the baby (although they assured me they were indeed not). They continued to lean into me and push for about 30 seconds. Breathing was nearly impossible, though I did manage a few short, shallow breaths.

When they finally stopped, they did another ultrasound to see if they had been successful. My doctor looked at the screen and said the baby may have moved a few inches, but was basically in the same position. We decided to give it one more go, so I bore down and prepared for a second round of pushing. Another 30 seconds of intense pressure and pushing (I think it was worse than labor), but the baby wouldn't budge.

I was so surprised because the ECV videos I had watched on YouTube in preparation had gone so smoothly. You could actually see the baby turning in the mother's belly. No such luck for me, though. My doctor told me he wouldn't advise trying it again (and I had no interest in going through that a second time), and I joked that I was 100-percent sure they gave it their all based on how uncomfortable it was.

They hooked me and the baby back up to all of our monitors and told me to settle in for three hours of monitoring. They had to be sure the procedure hadn't caused too much stress for the baby's heart. I knew that this was a possibility, as well as the main risk of the procedure. By keeping an eye on both of us for the next few hours, they could quickly whisk me away to deliver the baby if any complications arose.

Luckily, none did. Because of the baby's position, though, they recommended that I stay and have a C-section. If I went into labor, there was the possibility of the cord prolapsing, which could be very dangerous for the baby. Knowing there was even a chance this could turn into an emergency situation for myself and my baby, I chose to stay and deliver my child.

Our baby boy was delivered at exactly 12:43 p.m. that afternoon. It turns out there were a couple of reasons he may have chosen to stay right where he was instead of turning. First of all, he was a fairly large baby — 9 lbs., 1.6 oz. — and second, his hands were sticking straight up into my ribs. My midwife told me that babies usually have a reason for staying where they are. I've been told that we don't get to choose how our babies come into the world; I am just grateful that he is here.

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